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Individual

AMANDA LYNN BLOKING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1013 FARMINGTON AVE, WEST HARTFORD, CT 06107-2181
(860) 236-9004
Mailing address
1013 FARMINGTON AVE, WEST HARTFORD, CT 06107-2181
(860) 830-2626

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
332H00000X
Eyewear Supplier
Primary
1695
CT

Other

Enumeration date
04/14/2015
Last updated
06/15/2022
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