Individual
MS. JUDITH ANN BLAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC - SLP
Contact information
Practice address
1209 LITCHBOROUGH WAY, WAKE FOREST, NC 27587-3614
(919) 624-0849
Mailing address
1209 LITCHBOROUGH WAY, WAKE FOREST, NC 27587-3614
(919) 624-0849
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4654
NC
Other
Enumeration date
03/06/2019
Last updated
03/06/2019
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