Individual
ALICE DESHELIA BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
3101 SUPERIOR DR NW, ROCHESTER, MN 55901-1993
(507) 292-1006
Mailing address
818 NORTH BLVD, OAK PARK, IL 60301-1302
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/13/2026
Last updated
04/13/2026
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