Provider Demographics
NPI:1326677022
Name:BLYE, HELAINE (SLP)
Entity Type:Individual
Prefix:MRS
First Name:HELAINE
Middle Name:
Last Name:BLYE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 ROUTE 112 UNIT 1304
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11763-6054
Mailing Address - Country:US
Mailing Address - Phone:180-421-1323
Mailing Address - Fax:631-569-5718
Practice Address - Street 1:15 PITCHPINE PL
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NY
Practice Address - Zip Code:11763-4208
Practice Address - Country:US
Practice Address - Phone:800-421-1323
Practice Address - Fax:631-569-5718
Is Sole Proprietor?:No
Enumeration Date:2020-04-04
Last Update Date:2020-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009539235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist