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Individual
ALEXANDRIA JENICE BLACKMAN
Active
Individual
ALEXANDRIA JENICE BLACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
374700000X
Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y9514882
DRIVER LICENSE
CA
Enumeration date
01/25/2023
Last updated
01/26/2023
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