Individual
MRS. SUSAN MARIE BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
323 4TH ST, SLATINGTON, PA 18080-1708
(610) 767-2925
Mailing address
323 4TH ST, SLATINGTON, PA 18080-1708
(610) 767-2925
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP001075L
PA
Other
Enumeration date
10/14/2008
Last updated
10/14/2008
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