Individual
MRS. NANETTE ANN BLANDFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SPEECH THERAPIST
Contact information
Practice address
815 TRIPLETT ST, WENDELL FOSTERS CAMPUS FOR DEVELOPMENTAL DISABILITIES, OWENSBORO, KY 42303
(270) 683-4517
(270) 852-1491
Mailing address
PO BOX 1668, 815 TRIPLETT ST, OWENSBORO, KY 42302-1668
(270) 683-4517
(270) 852-1491
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2978
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11903135
MEDICAID ICF
KY
01
—
33000035
MEDICAID SCL
KY
05
—
45118379
—
KY
Enumeration date
06/29/2007
Last updated
07/09/2007
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