Individual
CORRINE BLAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
3186 AIRWAY AVE STE A, COSTA MESA, CA 92626-4650
(714) 881-0427
Mailing address
3186 AIRWAY AVE STE A, COSTA MESA, CA 92626-4650
(714) 881-0427
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP28697
CA
235Z00000X
Speech-Language Pathologist
TSLP10755
AZ
Other
Enumeration date
09/19/2017
Last updated
09/18/2020
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