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1952457012
BETTY A BLACKMON
RIDGELAND, MS
NPI
1952457012
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: MS OT1628)
Enumeration Date
2007-01-25
Last Update Date
2007-07-08
Business Address
-- BETTY A BLACKMON OTR-L
711 AVIGNON DR
RIDGELAND, MS 39157-5120
Phone number: 601-605-6777
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Mailing Address
-- BETTY A BLACKMON OTR-L
315 VIKING DR
COLUMBUS, MS 39702-8390
Phone number: 662-327-1252
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