Individual
WESLEY SHANE BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCC-SLP
Contact information
Practice address
150 LINCOLN ST, NEEDHAM, MA 02492-2914
(781) 449-4040
Mailing address
2 HANCOCK STREET, APARTMENT 322, QUINCY, MA 15427
(724) 288-8779
(724) 288-8779
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
76489
MA
Other
Enumeration date
08/20/2018
Last updated
08/20/2018
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