Individual
LESA N BLACKHURST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC, SLP
Contact information
Practice address
11725 N ILLINOIS ST, STE 445, CARMEL, IN 46032-3010
(317) 844-7059
(317) 573-4352
Mailing address
9002 N MERIDIAN ST, STE 222, INDIANAPOLIS, IN 46260-5350
(317) 573-4370
(317) 819-0044
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
22003848A
IN
235Z00000X
Speech-Language Pathologist
Primary
22003848A
IN
Other
Enumeration date
09/18/2008
Last updated
12/02/2013
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