Individual
MRS. KELLY BLANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1020 DUTCH FORK RD, IRMO, SC 29063-8822
(803) 476-8000
Mailing address
1020 DUTCH FORK RD, IRMO, SC 29063-8822
(803) 476-8000
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
09/19/2014
Last updated
09/19/2014
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