Individual
SHELLY BLANKENSHIP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS,OTR/L
Contact information
Practice address
1330 YMCA DR, SUITE 1200, FESTUS, MO 63028-2661
(314) 313-1088
Mailing address
3309 CRYSTAL LAKE DR, FESTUS, MO 63028-4274
(314) 313-1088
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2000175372
MO
Other
Enumeration date
09/20/2016
Last updated
09/20/2016
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