NPI 1093482325 · live from the CMS NPI Registry
Carly Blose
Speech-Language Pathologist, in Newark, DE. National Provider Identifier 1093482325, active.
NPI record
| NPI | 1093482325 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Speech-Language Pathologist, 235Z00000X |
| Practice location | 55 S Meadowood Dr, Newark, DE 19711 |
| Practice phone | 484-994-9635 |
| Mailing address | 2021 S 12th St, Philadelphia, PA 19148 |
| Enumerated | August 25, 2021 |
| Last updated | August 25, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Speech-Language Pathologist, primary | 235Z00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.