Individual
MADELINE BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
29655 PROKOP RD, ALBANY, LA 70711-3800
(985) 320-6285
Mailing address
29655 PROKOP RD, ALBANY, LA 70711-3800
(985) 320-6285
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
08/21/2019
Last updated
08/21/2019
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