Individual
JESSICA BLATCHLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 LEO MOSS DR, OLEAN, NY 14760-1100
(716) 373-8040
(716) 701-3728
Mailing address
1 LEO MOSS DR, OLEAN, NY 14760-1100
(716) 373-8040
(716) 701-3728
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00635098
—
NY
Enumeration date
02/04/2014
Last updated
02/04/2014
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