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Individual

BRANDON ANTHONY BLACKWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTR/L

Contact information

Practice address
1900 L ST NW STE 607, WASHINGTON, DC 20036-5047
(202) 528-7223
Mailing address
14700 4TH ST APT 216, LAUREL, MD 20707-3964
(216) 409-1045

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
08448
MD
225X00000X
Occupational Therapist
0T010001475
DC

Other

Enumeration date
05/18/2019
Last updated
05/18/2019
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