Individual
DENA BLACKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5223 ARQUILLA DR, RICHTON PARK, IL 60471-1519
(708) 516-3138
Mailing address
5223 ARQUILLA DR, RICHTON PARK, IL 60471-1519
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
IL
Other
Enumeration date
05/16/2007
Last updated
07/08/2007
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