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Individual

BLAKE COLBURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
5609 MILLER AVE, DALLAS, TX 75206-6428
(432) 687-4830
Mailing address
5609 MILLER AVE, DALLAS, TX 75206-6428

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
111429
TX

Other

Enumeration date
04/11/2017
Last updated
04/11/2017
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