Individual
JAMIE LYNN BLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
600 N COMMONS DR STE 102, AURORA, IL 60504-4155
(708) 478-1820
Mailing address
419 MADISON ST, LOCKPORT, IL 60441-3065
(815) 715-0026
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.005001
IL
Other
Enumeration date
08/27/2018
Last updated
08/27/2018
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