Individual
MEGAN R. BLAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15009 BLACKHAWK RD, OTTUMWA, IA 52501-8701
(641) 680-9972
Mailing address
15009 BLACKHAWK RD, OTTUMWA, IA 52501-8701
(641) 680-9972
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
IA
Other
Enumeration date
12/09/2024
Last updated
12/09/2024
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