Individual
MS. MALLERIE JANE BLEVINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
302 CEDAR RIDGE RD, CHARLESTON, WV 25320-9502
(304) 208-6582
Mailing address
646 FLORIDA ST, MILTON, WV 25541-1412
(304) 208-6582
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
244
WV
Other
Enumeration date
07/21/2021
Last updated
07/21/2021
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