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General NPI Number Information
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NPI Number | 1225288301
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Entity Type | Individual
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Provider Name | DIANA G BLANKENSHIP S.L.P.
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Gender | Female
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Dates
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Enumeration Date | 09/24/2008
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Last Update Date | 12/02/2022
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Provider Practice Location Address
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Address Line | 902 N 10TH ST
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City | KILLEEN
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State | TX
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Zip | 76541-4829
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Country | US
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Telephone | 254-336-6928
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2676
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City | HARKER HEIGHTS
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State | TX
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Zip | 76548-0676
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Country | US
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Telephone | 940-445-7934
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Fax |
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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 | 100130
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License Number State | TX
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