Individual
MRS. MICHELLE BOTTO-BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
190 KETTON XING, DULUTH, GA 30097-7139
(770) 846-9856
Mailing address
190 KETTON XING, DULUTH, GA 30097-7139
(770) 846-9856
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP005780
GA
Other
Enumeration date
08/06/2007
Last updated
08/06/2007
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