NPI 1457004590 · live from the CMS NPI Registry
Kizzy M Blackwell
Behavior Analyst in Middletown, DE. National Provider Identifier 1457004590, active.
NPI record
| NPI | 1457004590 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 108 Patriot Dr Ste A-5, Middletown, DE 19709 |
| Practice phone | 302-803-2210 |
| Enumerated | January 29, 2022 |
| Last updated | October 30, 2024 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst primary | 103K00000X | 1-23-70415 |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.