Most Relevant Information
Provider Data
| NPI Number: | 1003389693 |
| Provider Name: | JESSICA BLAIR OCCUPATIONAL THERAPY |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: | 5202008094 |
Most Important Dates
| Enumeration Date: | 01/07/2019 |
| Last Updated: | 08/19/2022 |
Provider Practice Location
210 TOWN CENTER DR
TROY
MI
480841774
Practice Location Phone/Fax
| Phone: | 8668128896 |
| Fax: |
Provider Mailing Location
5 REVERE DR STE 120
NORTHBROOK
IL
600628005
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |