Individual
MAGAN BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
927 FRANKLIN ST SE, HUNTSVILLE, AL 35801-4306
(256) 539-2728
Mailing address
1100 ENTERPRISE WAY NW APT 4207, HUNTSVILLE, AL 35806-3254
(205) 600-9801
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5568
AL
Other
Enumeration date
03/24/2021
Last updated
04/08/2021
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