Provider Demographics
NPI:1245507698
Name:BLYMILLER, M. CHRISTINE (COTA)
Entity type:Individual
Prefix:MRS
First Name:M.
Middle Name:CHRISTINE
Last Name:BLYMILLER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:M.
Other - Middle Name:CHRISTINE
Other - Last Name:HERBST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:701 LENOX AVE
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:NY
Mailing Address - Zip Code:13421-1500
Mailing Address - Country:US
Mailing Address - Phone:315-363-9281
Mailing Address - Fax:315-363-9286
Practice Address - Street 1:701 LENOX AVE
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-1500
Practice Address - Country:US
Practice Address - Phone:315-363-9281
Practice Address - Fax:315-363-9286
Is Sole Proprietor?:No
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000809-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant