Individual
INDIA BLAKELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5121 E BROADWAY RD, MESA, AZ 85206-1305
(334) 722-0049
Mailing address
1731 HENDERSON HWY, TROY, AL 36079-8221
(334) 722-0049
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTH-009798
AZ
Other
Enumeration date
12/03/2025
Last updated
12/03/2025
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