Individual
LELA BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2221 COTTAGE ST, GRAND ISLAND, NE 68803-2012
(402) 276-6240
Mailing address
2221 COTTAGE ST, GRAND ISLAND, NE 68803-2012
(402) 276-6240
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/09/2024
Last updated
05/09/2024
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