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Christopher Blake, MACCCSLP

Speech-Language Pathologist, in Eagan, MN. Individual provider (NPI-1).

NPI number1831238591
StatusActive
Last updated in NPPESNov 30, 2015

Details

NPI
1831238591
Entity type
Individual (NPI-1)
Name
Christopher Blake
Credential
MACCCSLP
Sex
Male
Sole proprietor
No
Enumeration date
Feb 6, 2007
Last updated
Nov 30, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
235Z00000X Speech-Language Pathologist,6349MNYes

Practice location

2795 Pilot Knob Rd
Suite #100
Eagan, MN 55121-1119

Phone 651-994-9644 · Fax 651-994-8962

Mailing address

4058 Deerwood Trl
Eagan, MN 55122-1889

Phone 651-994-9644 · Fax 651-994-8962

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