Blackwell, Tori Breanne

Blackwell, Tori Breanne is an individual health care provider with primary practice located at 3731-A 6Th Avenue , San Diego CA 92103. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Blackwell, Tori Breanne can be contacted via phone (619) 291-3515.

Contact Information

Primary practice address
3731-A 6Th Avenue San Diego CA 92103
Phone: (619) 291-3515
Fax: (619) 374-2552
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X OT007091 Georgia

Profile Details

NPI number 1689151284
LBN Legal business name Blackwell, Tori Breanne
Credentials MOT, OTR/L
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2018
Last updated Feb 20th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689151284 NPPES
Georgia Other OT007091 STATE BOARD OF OCCUPATIONAL THERAPY

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