Mr Peter Russell Blackman Jr, | |
1140 Shirley Rd, Bunkie, LA 71322-1545 | |
(318) 346-8001 | |
(318) 346-8005 |
Full Name | Mr Peter Russell Blackman Jr |
---|---|
Gender | Male |
Speciality | Counselor |
Location | 1140 Shirley Rd, Bunkie, Louisiana |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1609233907 | NPI | - | NPPES |
1544761 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | 1544761 (Louisiana) | Primary |
101YM0800X | Counselor - Mental Health | 1544761 (Louisiana) | Secondary |
Mailing Address | Practice Location Address |
---|---|
Mr Peter Russell Blackman Jr, 2260 Valley Street Po Box 205, Mansura, LA 71350-0205 Ph: (318) 346-8001 | Mr Peter Russell Blackman Jr, 1140 Shirley Rd, Bunkie, LA 71322-1545 Ph: (318) 346-8001 |
Chelsea Garin, Counselor Medicare: Not Enrolled in Medicare Practice Location: 109 Chevy Lane, Suite C, Bunkie, LA 71322 Phone: 318-346-6542 Fax: 318-346-6543 | |
Lashaitrend Berry, Counselor Medicare: Not Enrolled in Medicare Practice Location: 408 Floyd St, Bunkie, LA 71322 Phone: 318-613-6015 | |
Darryl Honor, Counselor Medicare: Not Enrolled in Medicare Practice Location: 109 Chevy Ln Ste C, Bunkie, LA 71322 Phone: 318-346-6542 | |
Demarcus Dwayne Friels, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1140 Shirley Rd, Bunkie, LA 71322 Phone: 318-346-8001 Fax: 318-346-8005 | |
Stacy Enette, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1140 Shirley Rd, Bunkie, LA 71322 Phone: 318-346-8001 Fax: 318-346-8005 | |
Mr. Zacchaeus Trey Murray, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1140 Shirley Rd, Bunkie, LA 71322 Phone: 318-346-8001 Fax: 318-346-8005 | |
Felice Edwards, Counselor Medicare: Not Enrolled in Medicare Practice Location: 109 Chevy Ln, C, Bunkie, LA 71322 Phone: 318-346-6542 Fax: 318-346-6543 |