Provider Demographics
NPI:1659699387
Name:BLACKNER, BARBARA J (MSW, CSW)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:J
Last Name:BLACKNER
Suffix:
Gender:F
Credentials:MSW, CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 N MALL DR STE A101
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-7303
Mailing Address - Country:US
Mailing Address - Phone:435-628-8075
Mailing Address - Fax:435-628-0252
Practice Address - Street 1:321 N MALL DR STE A101
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-7303
Practice Address - Country:US
Practice Address - Phone:435-628-8075
Practice Address - Fax:435-628-0252
Is Sole Proprietor?:No
Enumeration Date:2010-05-05
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3307-94-3502UT1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical