Individual
JAMIE RENAE VAN BLARCOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA/L
Contact information
Practice address
20560 BINNEY ST, ELKHORN, NE 68022-2092
(402) 321-1610
Mailing address
20560 BINNEY ST, ELKHORN, NE 68022-2092
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
324
NE
224Z00000X
Occupational Therapy Assistant
509
IA
Other
Enumeration date
11/21/2018
Last updated
11/21/2018
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