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1770186108
AUSTIN BLACKLOCK
FORT WORTH, TX
NPI
1770186108
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: TX 116338)
Enumeration Date
2020-11-18
Last Update Date
2020-11-18
Business Address
AUSTIN BLACKLOCK
8101 BOAT CLUB RD STE 160
FORT WORTH, TX 76179-3631
Phone number: 214-302-9725
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Mailing Address
AUSTIN BLACKLOCK
8101 BOAT CLUB RD STE 160
FORT WORTH, TX 76179-3631
Phone number: 214-302-9725
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