Individual
KOFFI BLEWOUSSI AZIANKOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
120 HORSE TRAIL LN, FELTON, DE 19943-6648
(732) 598-9600
Mailing address
120 HORSE TRAIL LN, FELTON, DE 19943-6648
(732) 598-9600
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
U2-0012311
DE
Other
Enumeration date
12/05/2025
Last updated
12/05/2025
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