Individual
HALEY AMANDA BLACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3395 PLYMOUTH RD, MINNETONKA, MN 55305-3633
(952) 939-0396
Mailing address
8988 PEONY LN N, MAPLE GROVE, MN 55311-4445
(936) 671-1045
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
528791
MN
Other
Enumeration date
08/26/2019
Last updated
02/21/2024
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