Individual
MRS. SHEILA MARIE BLAZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCCSLP
Contact information
Practice address
600 NORTH PRESTON STREET, RANSON ELEMENTARY SCHOOL, RANSON, WV 25438
(304) 725-7310
Mailing address
37 BUTCHER COURT, SHEPHERDSTOWN, WV 25443
(304) 876-3739
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4853
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810005072
—
WV
Enumeration date
01/07/2008
Last updated
01/07/2008
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