Individual
CONNIE BLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
9777 N COUNCIL RD APT 727, OKLAHOMA CITY, OK 73162-5551
(405) 474-6885
Mailing address
14715 BRISTOL PARK BLVD, EDMOND, OK 73013-1894
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT#460
OK
225XP0200X
Pediatric Occupational Therapist
OT#460
OK
Other
Enumeration date
08/22/2011
Last updated
08/31/2011
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