Provider Demographics
NPI:1891427100
Name:BLAIR, VANESSA ORETTA (MA SLP-CFY TSSLD)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:ORETTA
Last Name:BLAIR
Suffix:
Gender:F
Credentials:MA SLP-CFY TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 BROOKLYN AVE APT 5E
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-1902
Mailing Address - Country:US
Mailing Address - Phone:347-283-2175
Mailing Address - Fax:
Practice Address - Street 1:65 COURT STREET
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4916
Practice Address - Country:US
Practice Address - Phone:718-935-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant