NPI 1225899602 · live from the CMS NPI Registry
Andrew Blake, CCC-SLP
Speech-Language Pathologist, in Salt Lake City, UT. National Provider Identifier 1225899602, active.
NPI record
| NPI | 1225899602 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Speech-Language Pathologist, 235Z00000X |
| Practice location | 1200 E 3900 S, Salt Lake City, UT 84124 |
| Practice phone | 801-293-6800 |
| Mailing address | 2170 S Mcclelland St Apt 320, Salt Lake City, UT 84106 |
| Enumerated | January 22, 2024 |
| Last updated | March 4, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Speech-Language Pathologist, primary | 235Z00000X | 12379664-4102 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.