Individual
KANDACE BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
863 HATHAWAY RD, NEW BEDFORD, MA 02740-1916
(803) 261-9039
Mailing address
1755 WITTINGTON PL, STE. #175, DALLAS, TX 75234-1927
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP-9750-SL
MA
Other
Enumeration date
12/17/2015
Last updated
12/17/2015
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