Individual
WILLIAM BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
648 CRESTWOOD BLVD, COVINGTON, LA 70433-8261
(985) 805-2555
Mailing address
648 CRESTWOOD BLVD, COVINGTON, LA 70433-8261
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7785
LA
Other
Enumeration date
08/09/2019
Last updated
08/09/2019
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