Blacknall, Gwendolyn Marcella

Blacknall, Gwendolyn Marcella is an individual health care provider with primary practice located at 65 Duke St Ste 203 , Prince Frederick MD 20678-6128. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Blacknall, Gwendolyn Marcella can be contacted via phone (443) 824-4818.

Contact Information

Primary practice address
65 Duke St Ste 203 Prince Frederick MD 20678-6128
Phone: (443) 824-4818
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LGA2466 Maryland

Profile Details

NPI number 1275171217
LBN Legal business name Blacknall, Gwendolyn Marcella
Credentials LGADC
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 19th, 2019
Last updated Dec 19th, 2019 - about 7 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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