Individual
MS. BLAZE DANIELLE EARLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
49 MONTROSE AVE, BROOKLYN, NY 11206-2580
(718) 473-3808
Mailing address
33 CROOKE AVE APT 1D, BROOKLYN, NY 11226-1144
(732) 513-2512
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
029345-01
NY
Other
Enumeration date
01/21/2020
Last updated
01/21/2020
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