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General NPI Number Information
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NPI Number | 1154528347
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Entity Type | Individual
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Provider Name | NANETTE ANN BLANDFORD SPEECH THERAPIST
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Gender | Female
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 815 TRIPLETT ST WENDELL FOSTERS CAMPUS FOR DEVELOPMENTAL DISABILITIES
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City | OWENSBORO
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State | KY
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Zip | 42303
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Country | US
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Telephone | 270-683-4517
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Fax | 270-852-1491
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Provider Business Mailing Address
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Address Line | PO BOX 1668 815 TRIPLETT ST
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City | OWENSBORO
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State | KY
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Zip | 42302-1668
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Country | US
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Telephone | 270-683-4517
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Fax | 270-852-1491
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2978
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License Number State | KY
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