Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 32001609 | IN |
NPI | 1033363692 |
---|---|
Provider Name | Mrs. Erin Nicole Blair |
First Address | Albany, IN 47320 |
Second Address | Albany, IN 47320-1530 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2008 |
Last Update Date | 10/11/2008 |