Individual
MRS. JENNIFER LYNN BLAZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
4 HAZEL AVE, NAUGATUCK, CT 06770-4706
(203) 720-3411
Mailing address
47 DUNBAR LN, HAMDEN, CT 06514-1936
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
001771
CT
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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