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
| License | State | Type | Specialty |
|---|---|---|---|
| 2010015840 | MO | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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- Abby Leanne Beyer
- Bailee Bonastia
- Betty Bossaller
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- Madison Lee Brocato
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All providers in Wildwood, MO · Speech-Language Pathologist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 22, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.