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Individual

CAROLYN BLAISDELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS OTR/L

Contact information

Practice address
3525 E LOUISE DR, MERIDIAN, ID 83642-6302
(208) 489-5099
Mailing address
12234 W AUCKLAND ST, BOISE, ID 83709-5289
(434) 825-5091

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-963
ID

Other

Enumeration date
08/28/2014
Last updated
02/26/2025
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