The holder whose full name is Blackman, Theresa Lynn,come from Fort Wayne IN,hold the Addiction Counselor license(NO.86000319A) which status is Active.
| Name | Blackman, Theresa Lynn |
|---|---|
| License Number | 86000319A |
| License Type | Addiction Counselor |
| License Status | Active |
| City | Fort Wayne |
| State | IN |