Individual
KELLY BLICKENSTAFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
15 WALKER AVE, PIKESVILLE, MD 21208-4023
(410) 358-1997
(866) 840-6040
Mailing address
15 WALKER AVE, PIKESVILLE, MD 21208-4023
(410) 358-1997
(866) 840-6040
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
07657
MD
Other
Enumeration date
03/19/2015
Last updated
04/25/2025
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