Individual
MRS. TINA MARIE BLACKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
835 TENDERFOOT HILL RD, COLORADO SPRINGS, CO 80906-3903
(719) 226-6530
Mailing address
35 MOBRAY CT, COLORADO SPRINGS, CO 80906-7680
(719) 527-8215
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
982658
CO
Other
Enumeration date
12/07/2012
Last updated
12/07/2012
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