Individual
DANIELLE CLAIRE BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
540 TUCKER AVE, JEFFERSON, LA 70121-1571
(504) 906-1703
Mailing address
540 TUCKER AVE, JEFFERSON, LA 70121-1571
(504) 906-1703
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
11/27/2017
Last updated
11/27/2017
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