Individual
MOLLIE SULLIVAN BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
420 E GRUNDY AVE, SPRINGFIELD NSG AND REHAB CENTER, SPRINGFIELD, KY 40069-1173
(859) 336-7771
Mailing address
40 MILES AVE, APT 2, LORETTO, KY 40037-8050
(270) 865-3615
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
KY-R2901
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12500872
—
KY
Enumeration date
06/28/2007
Last updated
07/08/2007
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