Individual
MS. ROSIE BLACKSTOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
411 AIRPORT RD, SULPHUR SPRINGS, TX 75482-2005
(903) 885-1483
Mailing address
2113 W KAUFMAN ST, PARIS, TX 75460-5445
(903) 782-9298
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
204992
TX
Other
Enumeration date
10/10/2007
Last updated
10/10/2007
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