Individual
MARY DEBLONDIN-CHASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC/SLP
Contact information
Practice address
11506 NICHOLAS ST, SUITE 110, OMAHA, NE 68154-4407
(877) 230-3885
(402) 505-9753
Mailing address
11506 NICHOLAS ST, SUITE 110, OMAHA, NE 68154-4407
(877) 230-3885
(402) 505-9753
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
1070
KY
235Z00000X
Speech-Language Pathologist
Primary
15064
OR
235Z00000X
Speech-Language Pathologist
SL011501
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1070
KENTUCKY LICENSE NUMBER
KY
01
—
15064
OREGON LICENSE
OR
01
—
SL011501
PA LICENSE
PA
Enumeration date
08/13/2013
Last updated
08/13/2013
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