Individual
CASEY JEAN BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSCFSLP
Contact information
Practice address
1811 MEMORIAL DR, CLARKSVILLE, TN 37043-4604
(931) 801-5131
Mailing address
2307 CRYSTAL SPRING LN, HERMITAGE, TN 37076-4196
(812) 453-9353
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3680
TN
Other
Enumeration date
07/08/2010
Last updated
07/08/2010
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