Individual
MS. MIRANDA MARIE BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
1313 41ST ST, ANACORTES, WA 98221-3512
(360) 503-1556
Mailing address
1313 41ST ST, ANACORTES, WA 98221-3512
(360) 503-1556
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL0004514
WA
Other
Enumeration date
09/22/2016
Last updated
09/22/2016
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