Individual
MRS. BROOKE Q LUNDAHL BLAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
622 WEST 168TH STREET, NEW YORK, NY 10032-3784
(212) 305-4958
Mailing address
704 JERSEY AVE, JERSEY CITY, NJ 07302-1312
(718) 916-9326
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
016259-1
NY
Other
Enumeration date
05/10/2007
Last updated
07/08/2007
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