Individual
MRS. AMY DENISE BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MCD, CFY-SLP
Contact information
Practice address
1110 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3336
(573) 785-6707
Mailing address
765 HIGHWAY F, HARVIELL, MO 63945-8127
(573) 776-8203
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2008037336
MO
Other
Enumeration date
01/12/2009
Last updated
01/12/2009
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