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Individual

JANA MICHELLE BLEVINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS CCC-SLP

Contact information

Practice address
50495 E 100 RD, MIAMI, OK 74354-6073
(139) 272-2979
Mailing address
50495 E 100 RD, MIAMI, OK 74354-6073
(191) 392-7229

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2018013326
MO
235Z00000X
Speech-Language Pathologist
2449
KS

Other

Enumeration date
06/07/2007
Last updated
03/22/2021
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