Emily Blackbourn
Technician, Other in Wayne, MI. Individual provider (NPI-1).
NPI number1699179986
StatusActive
Last updated in NPPESOct 15, 2014
Details
- NPI
- 1699179986
- Entity type
- Individual (NPI-1)
- Name
- Emily Blackbourn
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 15, 2014
- Last updated
- Oct 15, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 247200000X | Technician, Other | – | – | Yes |
Practice location
35640 W Michigan AveWayne, MI 48184-1628
Phone 734-729-7938
Mailing address
35640 W Michigan AveWayne, MI 48184-1628
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