Individual
MAKAYLA BLACKMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 S WINMERE AVE, SELMA, IN 47383-9427
(765) 748-8328
Mailing address
500 S WINMERE AVE, SELMA, IN 47383-9427
(765) 748-8328
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-20-114191
IN
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
06/02/2021
Last updated
12/05/2022
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