| Doctor Name: | MARY ELIZABETH BLONDIN |
| NPI Number: | 1154637924 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLP |
| License Number: | 0772 |
| Business Practice Address: | 2212 Outer Circle Dr Crestwood, KY - 400149113 |
| Business Phone Number: | 5028360701 |
| Business Fax Number: | 5022439848 |
| Mailing Address: | 1318 Morgan Ave, LOUISVILLE |
| State: | KY |
| Postal Code: | 402131722 |
| Phone Number: | 5025928554 |
| Fax Number: | |
| NPI Enumeration Date: | 08/31/2010 |
| NPI Last Update Date: | 08/31/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 0772 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |