Provider Demographics
NPI:1548726144
Name:BLACKWELL, BARBARA ANN
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:BLACKWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9021 SUN COUNTRY DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-3211
Mailing Address - Country:US
Mailing Address - Phone:405-455-5033
Mailing Address - Fax:
Practice Address - Street 1:9021 SUN COUNTRY DR
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-3211
Practice Address - Country:US
Practice Address - Phone:510-681-1077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-19
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)