Individual
BLAKELY ELIZABETH VINAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
731 POLO RD, COLUMBIA, SC 29223-4462
(803) 788-5115
Mailing address
102 DELAHUNTY DR, SOUTHINGTON, CT 06489-3667
(860) 384-5689
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
08/16/2021
Last updated
08/16/2021
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