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Individual

BLAKE GELLNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
830 KIRTS BLVD STE 305, TROY, MI 48084-4892
(124) 876-0212
Mailing address
830 KIRTS BLVD STE 305, TROY, MI 48084-4892
(124) 876-0212

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
1803
WV
235Z00000X
Speech-Language Pathologist
Primary
7101005800
MI

Other

Enumeration date
08/10/2017
Last updated
09/18/2018
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