National Provider Identifier

Mary Blackley

Mary Blackley is listed in the NPPES registry with a primary specialty of Pediatric Occupational Therapist in Kenmore, NY and a listed phone number of (716) 874-6175.

NPI 1053077065Kenmore, NYPediatric Occupational Therapist

Profile Overview

NPI
1053077065
Provider Type
Individual
Primary Specialty
Pediatric Occupational Therapist
Enumeration Date
November 14, 2021
Last Updated
November 14, 2021

Practice Location

  • 3767 Delaware Ave
  • Kenmore, NY 14217-1040

Phone: (716) 874-6175

Specialties

  • Pediatric Occupational Therapist (225XP0200X)
Full Record
NPI
1053077065
Entity Type
Individual
Last Name
Blackley
First Name
Mary
Mailing Street Address
3767 Delaware Ave
Mailing City
Kenmore
Mailing State
NY
Mailing ZIP Code
14217-1040
Mailing Country
US
Practice Street Address
3767 Delaware Ave
Practice City
Kenmore
Practice State
NY
Practice ZIP Code
14217-1040
Practice Country
US
Practice Phone
(716) 874-6175
Enumeration Date
November 14, 2021
Last Updated
November 14, 2021
Sex
Female
Sole Proprietor
No
Certification Date
November 14, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Pediatric Occupational Therapist (225XP0200X)