Doctor Name: | MRS. LENNIS REBECCA BLACKBURN |
NPI Number: | 1619304987 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.E.,CCC/SLP |
License Number: | 2357 |
Business Practice Address: | 150 Hurricane Vly Hardeeville, SC - 299274056 |
Business Phone Number: | 8437848400 |
Business Fax Number: | |
Mailing Address: | 4 Devant Ct, BLUFFTON |
State: | SC |
Postal Code: | 299094535 |
Phone Number: | 8437055538 |
Fax Number: | |
NPI Enumeration Date: | 10/02/2013 |
NPI Last Update Date: | 10/02/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2357 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
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 |