Doctor Name: | MS. JENNIFER LYNN BLAKE |
NPI Number: | 1508198078 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SPEECH LANGUAGE PATH |
License Number: | SA 5267 |
Business Practice Address: | 3161 Sw 50th St Ft. Lauderdale, FL - 33312 |
Business Phone Number: | 9548949023 |
Business Fax Number: | |
Mailing Address: | 3161 Sw 50th St, FT LAUDERDALE |
State: | FL |
Postal Code: | 333126982 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 02/08/2010 |
NPI Last Update Date: | 02/08/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA 5267 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
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 |