Individual
JEANA THERESE BLAKESLEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1440 OCEAN RD, WALL TOWNSHIP, NJ 07719-9003
(732) 539-9865
Mailing address
1440 OCEAN RD, WALL TOWNSHIP, NJ 07719-9003
(732) 539-9865
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
46TA09060600
NJ
Other
Enumeration date
04/05/2021
Last updated
04/05/2021
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