Individual
BLAINE ELIZABETH POE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
510 MITCHELL AVENUE, MOUNT VERNON, OH 43050
(740) 501-2876
Mailing address
8402 BLACKJACK RD, MOUNT VERNON, OH 43050-9193
(740) 258-8465
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
171M00000X
QHMS
—
Enumeration date
08/22/2017
Last updated
08/21/2024
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