| NPI | 1922415876 |
|---|---|
| Former Name | CHELSEA DIANE BLACKMORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2014-07-11 |