Individual
MR. BLAIK J. WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
1025 N COUNTRY CLUB DR, MESA, AZ 85201-3307
(480) 472-0727
Mailing address
1025 N COUNTRY CLUB DR, MESA, AZ 85201-3307
(480) 472-0727
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0528
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
580391
—
AZ
Enumeration date
12/12/2006
Last updated
07/09/2007
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