Individual provider · Type 1 NPI
Juanita Blackmon, MS
Developmental Therapist · Chicago, IL
Practice location
5904 S Kedzie Ave Apt 303
Chicago, IL 60629-3216
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Developmental Therapist Primary | 222Q00000X | None listed |
Developmental Therapist: A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Deve…
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About NPI 1033764485
Juanita Blackmon, MS's National Provider Identifier is 1033764485, issued on Aug 2, 2019. The primary taxonomy on file is Developmental Therapist (222Q00000X), and the practice location is in Chicago, IL. The record was last updated on Aug 2, 2019.