Individual
MRS. SUMMER BENTLEY BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
515 S GENERALS BLVD, LINCOLNTON, NC 28092
(704) 735-8065
Mailing address
1845 JETTON DR, VALE, NC 28168-7611
(828) 302-6460
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4622
NC
Other
Enumeration date
10/20/2009
Last updated
10/20/2009
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