Individual
ANGELA BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1030 LOFTIS BLVD STE 103, NEWPORT NEWS, VA 23606-2999
(757) 720-0099
Mailing address
568 SANDHURST DR, FAYETTEVILLE, NC 28304-4426
(910) 484-1711
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131001582
VA
Other
Enumeration date
01/08/2024
Last updated
01/08/2024
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