Individual
CASSIDY BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DT
Contact information
Practice address
2626 SAINT JOE CENTER RD, FORT WAYNE, IN 46825-5042
(260) 497-0328
(260) 497-0904
Mailing address
2626 SAINT JOE CENTER RD, FORT WAYNE, IN 46825-5042
(260) 497-0328
(260) 497-0904
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
03/24/2022
Last updated
03/24/2022
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