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General NPI Number Information
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NPI Number | 1447971502
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Entity Type | Individual
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Provider Name | HALEY A BLACKBURN OTR/L
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Gender | Female
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Dates
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Enumeration Date | 09/07/2022
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Last Update Date | 09/07/2022
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Provider Practice Location Address
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Address Line | 2344 ELKHORN RD
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City | LEXINGTON
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State | KY
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Zip | 40509-2784
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Country | US
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Telephone | 859-788-2369
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Fax |
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Provider Business Mailing Address
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Address Line | 2213 LAKESIDE DR
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City | LEXINGTON
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State | KY
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Zip | 40502-3020
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Country | US
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Telephone | 859-321-6911
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 280468
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License Number State | KY
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