Individual
JENNIFER BLAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1404 S ELM ST, OTTAWA, KS 66067-3429
(785) 418-4691
Mailing address
1404 S ELM ST, OTTAWA, KS 66067-3429
(785) 418-4691
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18-01096
KS
Other
Enumeration date
01/22/2015
Last updated
01/22/2015
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