Lynette Bush Blackwell

NPI #1508303116 in Wheatley Heights, New York

Provider Information

NPI Number: 1508303116
Entity Type: Individual
Name: Lynette Bush Blackwell
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Jan 21, 2017
Last Updated: Jan 21, 2017

Practice Location

Address: 11 WILLOW ST
City: Wheatley Heights
State: New York
ZIP Code: 11798-1829
Phone: (631) 920-6542

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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