Individual
DR. JANE MARIE BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
898 MOLINARO CT, IVINS, UT 84738-6493
(801) 550-8707
Mailing address
898 MOLINARO CT, IVINS, UT 84738-6493
(801) 550-8707
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
112636-2501
UT
Other
Enumeration date
04/03/2007
Last updated
12/21/2011
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