Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | U10000043 | DE |
NPI | 1194800193 |
---|---|
Provider Name | Mrs. Janet W Blaylock |
First Address | Wilmington, DE 19808-5413 |
Second Address | Newark, DE 19713-2198 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2006 |
Last Update Date | 23/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1194800193 | (05) | DE |
2783018 | HIGHMARK (01) | DE |
3767397000 | IBC (01) | DE |
4586026 | (05) | MD |
AC44-0033 | CAREFIRST (01) | DE |
P00885362 | RAILROAD MEDICARE (01) | DE |