Individual
JESSICA BLACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
734 W 19TH ST, CASPER, WY 82601-4520
(307) 267-5549
Mailing address
734 W 19TH ST, CASPER, WY 82601-4520
(307) 267-5549
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
831
WY
225X00000X
Occupational Therapist
0007595
CO
225X00000X
Occupational Therapist
Primary
1670
WY
Other
Enumeration date
10/06/2014
Last updated
09/14/2022
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