Individual
ALLYSON BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
80 COLLEGE BLVD E, NICEVILLE, FL 32578-1343
(850) 279-3000
(850) 389-2269
Mailing address
80 COLLEGE BLVD E, NICEVILLE, FL 32578-1343
(850) 279-3000
(850) 389-2269
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
22-216162
FL
Other
Enumeration date
06/13/2022
Last updated
06/13/2022
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