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1023258613
BLAKE ILYSA ROSE
NEW YORK, NY
NPI
1023258613
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Former Name
BLAKE ILYSA SMALL
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: NY 015114)
Enumeration Date
2009-02-23
Last Update Date
2009-02-23
Business Address
-- BLAKE ILYSA ROSE MS CCC SLP
139 E 35TH ST 5E
NEW YORK, NY 10016-4176
Phone number: 516-410-8452
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Mailing Address
-- BLAKE ILYSA ROSE MS CCC SLP
139 E 35TH ST 5E
NEW YORK, NY 10016-4176
Phone number: 516-410-8452
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