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Contact Information

JANE M BLACKWELL, PhD
898 MOLINARO CT
IVINS, UT84738-6493
 Phone: 801-550-8707
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for JANE M BLACKWELL · (Female)

NPI Number 1841311875
Credentials PhD
Entity Individual
Enumeration date 04/03/2007
Last updated 12/21/2011 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
UT License # 112636-2501
UT Medicare (Unspecified) 000007496
Hospital affiliation(s) n/a
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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