Melissa Blake

Individual provider Active NPI Speech-Language Pathologist · Hastings, NE

NPI 1972052157 · NPPES record last updated Sep 28, 2016

Key facts

NPI
1972052157
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
Practice address
1924 W a St
Hastings, NE 68901-5650
Phone
(402) 461-7578
NPI assigned
Sep 28, 2016
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)
No

Specialties & licenses

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

Addresses

Primary practice location

1924 W a St
Hastings, NE 68901-5650

Mailing address

2324 W 11TH St
Grand Island, NE 68803-3622
Phone (308) 384-0317

Other identifiers

IdentifierTypeStateIssuer
473600101MedicaidNE

Other providers in Hastings, NE

All providers in Hastings, NE · Speech-Language Pathologist in Nebraska

Sources for this page

Verify at the official NPI Registry.