| Doctor Name: | MRS. COURTNEY LANGE BLEVINS |
| NPI Number: | 1578725966 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 2202005355 |
| Business Practice Address: | 2603 Osborne St Suite 1 Bristol, VA - 242012326 |
| Business Phone Number: | 2766696331 |
| Business Fax Number: | |
| Mailing Address: | 2603 Osborne St, Suite 1 BRISTOL |
| State: | VA |
| Postal Code: | 242012326 |
| Phone Number: | 2766696331 |
| Fax Number: | |
| NPI Enumeration Date: | 06/27/2008 |
| NPI Last Update Date: | 06/27/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 2202005355 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| 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 |