Individual
SARA BLACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
405 E RICHMOND ST, BROKEN ARROW, OK 74012-5642
(479) 883-4527
Mailing address
1304 S TYLER AVE, WAGONER, OK 74467-7823
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
CF586
OK
Other
Enumeration date
08/09/2023
Last updated
08/09/2023
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