Becky S Blackaby, MS CCC SLP

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

NPI 1386772093 · NPPES record last updated Dec 6, 2007

Key facts

NPI
1386772093
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
2003008347 (MO)
Practice address
740 Cleveland St
Paris, MO 65275-1120
Phone
(660) 327-5116
Fax
(660) 327-4290
NPI assigned
Mar 2, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2003008347MOMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Paris Board of Education Speech-Language Pathologist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2003008347 MO Yes

Addresses

Primary practice location

740 Cleveland St
Paris, MO 65275-1120

Mailing address

740 Cleveland St
Paris, MO 65275-1120
Phone (660) 327-5116

Other providers in Paris, MO

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

Sources for this page

Verify at the official NPI Registry.