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General NPI Number Information
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NPI Number | 1013870989
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Entity Type | Individual
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Provider Name | CASSIDY BLACKWIN
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Gender | Female
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Dates
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Enumeration Date | 12/06/2025
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Last Update Date | 12/13/2025
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Provider Practice Location Address
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Address Line | 1550 DICKSON AVE KELOWNA B.C.
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City | KELOWNA
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State | BRITISH COLUMBIA
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Zip | V1Y 9Y8
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Country | CA
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Telephone |
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Fax |
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Provider Business Mailing Address
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Address Line | 1550 DICKSON AVE KELOWNA B.C. 204
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City | KELOWNA
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State | BRITISH COLUMBIA
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Zip | V1Y 9Y8
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Country | CA
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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