Individual
DUSTIN BLACKINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
244 WESTERN AVENUE, SOUTH PORTLAND, ME 04106
(207) 775-3446
(207) 879-1646
Mailing address
244 WESTERN AVENUE, SOUTH PORTLAND, ME 04106
(207) 775-3446
(207) 879-1646
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
117258
TX
225X00000X
Occupational Therapist
Primary
OT3637
ME
Other
Enumeration date
10/22/2015
Last updated
11/25/2019
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