Mary K Bland, SLP

Individual provider Active NPI Speech-Language Pathologist · Wildwood, MO

NPI 1265748248 · NPPES record last updated Jun 22, 2018

Key facts

NPI
1265748248
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
2010015840 (MO)
Practice address
251 Plaza Dr
Wildwood, MO 63040
Phone
(636) 591-4887
NPI assigned
Aug 27, 2010
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2010015840MOMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2010015840 MO Yes

Addresses

Primary practice location

251 Plaza Dr
Wildwood, MO 63040

Mailing address

701 Ballantrae Dr
Wentzville, MO 63385-2875

Other names

  • Mary K Sansone Other name

Other providers in Wildwood, MO

All providers in Wildwood, MO · Speech-Language Pathologist in Missouri

Sources for this page

Verify at the official NPI Registry.