Individual
MS. KAREN SUE BLAISDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1660 CHERRY BLOSSOM LN, APT. 103, WINSTON SALEM, NC 27127-3226
(336) 403-3859
Mailing address
2227 DUNNING CT, HIGH POINT, NC 27265-9476
(336) 403-3859
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9369
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9245
CA STATE SLP LICENSE
CA
01
—
9369
NORTH CAROLINA LICENSE
NC
Enumeration date
03/19/2007
Last updated
07/31/2014
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