Blackmore, Willis Edwin
Blackmore, Willis Edwin is an sole proprietor health care provider with primary practice located at 1337 Gusdorf Road, Suites E & F , Taos NM 87571-6489. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Blackmore, Willis Edwin can be contacted via phone (575) 758-4297.Contact Information
Primary practice address
1337 Gusdorf Road, Suites E & F
Taos NM 87571-6489
Phone: (575) 758-4297
Fax: (575) 751-7237
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | M-04831 | New Mexico |
Profile Details
| NPI number | 1386846715 |
|---|---|
| LBN Legal business name | Blackmore, Willis Edwin |
| Credentials | LMSW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 5th, 2007 |
| Last updated | Feb 1st, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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