Individual
MRS. MELISSA L BLACKMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
108 EXECUTIVE PARK LN, SELMA, AL 36701-7734
(334) 875-2550
(334) 875-3654
Mailing address
113 CALVIN CIR, VALLEY GRANDE, AL 36703-8801
(334) 875-2550
(334) 875-3654
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1846
AL
Other
Enumeration date
04/23/2007
Last updated
07/08/2007
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