Individual
MARY CATHERINE BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLPA
Contact information
Practice address
9385 W DONALD DR, PEORIA, AZ 85383-2988
(602) 910-1409
Mailing address
1625 N DATE APT 2, MESA, AZ 85201-2158
(928) 386-4039
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
—
AZ
Other
Enumeration date
09/04/2019
Last updated
09/04/2019
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