Individual
MRS. LAIKEN BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1032 BOLL WEEVIL CIR STE E-G, ENTERPRISE, AL 36330-1381
(334) 677-6360
(334) 475-2021
Mailing address
118 ADRIS PL, DOTHAN, AL 36303-1997
(334) 677-6360
(334) 678-6540
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5526
AL
Other
Enumeration date
08/20/2024
Last updated
08/20/2024
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