Healthcare Provider Details

I. General information

NPI: 1588592463
Provider Name (Legal Business Name): TERRIE JEAN BLACHOWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2791 N ELLISTON TROWBRIDGE RD
GRAYTOWN OH
43432-9754
US

IV. Provider business mailing address

2791 N ELLISTON TROWBRIDGE RD
GRAYTOWN OH
43432-9754
US

V. Phone/Fax

Practice location:
  • Phone: 419-461-7366
  • Fax:
Mailing address:
  • Phone: 419-461-7366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: