Individual
KAMI LYNN BLACKHURST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT/L
Contact information
Practice address
2920 E SHELF RD, PRESCOTT, AZ 86303-8612
(928) 899-1266
Mailing address
PO BOX 26660, PRESCOTT VALLEY, AZ 86312-6660
(928) 899-1266
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT3804
AZ
Other
Enumeration date
07/12/2008
Last updated
07/12/2008
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