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Individual
CHRISTOPHER BLAKE
Active
Individual
CHRISTOPHER BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MACCCSLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6349
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
442612600
—
MN
01
—
4600244
MEDICA
MN
01
—
962S9BL
BCBS
MN
01
—
HP32576
HEALTH PARTNERS
MN
Enumeration date
02/06/2007
Last updated
11/30/2015
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