Individual
MARY K BLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
251 PLAZA DR, WILDWOOD, MO 63040
(636) 591-4887
Mailing address
701 BALLANTRAE DR, WENTZVILLE, MO 63385-2875
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2010015840
MO
Other
Enumeration date
08/27/2010
Last updated
06/22/2018
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