Individual
JULIE T BLACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
13602 S VILLAGE DR, #204, TAMPA, FL 33618-8334
(646) 544-4485
(813) 960-5483
Mailing address
13602 S VILLAGE DR, #204, TAMPA, FL 33618-8334
(646) 544-4485
(813) 960-5483
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
017705
NY
225X00000X
Occupational Therapist
46TR00606500
NJ
225X00000X
Occupational Therapist
Primary
OT 16418
FL
Other
Enumeration date
03/14/2013
Last updated
09/16/2014
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