Individual
TRISTA N BLADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
14130 23RD AVENUE NORTH, PLYMOUTH, MN 55447-4904
(763) 383-7666
(763) 383-6013
Mailing address
14130 23RD AVENUE NORTH, PLYMOUTH, MN 55447-4904
(763) 383-7666
(763) 383-6013
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9052
MN
Other
Enumeration date
02/12/2013
Last updated
01/04/2016
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