Individual
REBECCA BLACKARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8408 WHISKEY ISLAND RD, CAMDEN, NY 13316-3432
(936) 442-8227
Mailing address
1031 E FAYETTE ST, SYRACUSE, NY 13210-1022
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/25/2022
Last updated
07/25/2022
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