Individual
RENEE ADELE BLAISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
93 RICHARDS AVE, APT 110, NORWALK, CT 06854-1679
(631) 671-9183
Mailing address
93 RICHARDS AVE, APT 110, NORWALK, CT 06854-1679
(631) 671-9183
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
006887
NY
225200000X
Physical Therapy Assistant
1123
CT
225200000X
Physical Therapy Assistant
4636
MS
Other
Enumeration date
10/25/2010
Last updated
10/25/2010
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