Individual
DANIELLE BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAT/ATC
Contact information
Practice address
723 SAINT MARYS ST, RALEIGH, NC 27605-1424
(919) 856-7810
Mailing address
723 SAINT MARYS ST, RALEIGH, NC 27605-1424
(919) 856-7810
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1722
NC
Other
Enumeration date
11/27/2012
Last updated
12/03/2014
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