Individual
MS. RUTH PAULINE DISMUKE BLAKELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1090 MOUNTAIN VALLEY RD, EDGEWOOD, NM 87015-8044
(505) 281-1811
(505) 281-7704
Mailing address
PO BOX 2225, EDGEWOOD, NM 87015-2225
(505) 281-1811
(505) 281-7704
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2880
NM
Other
Enumeration date
03/13/2007
Last updated
07/08/2007
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