Provider Demographics
NPI:1801945845
Name:BLANKENSHIP, MICHELLE (MS CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:
Last Name:BLANKENSHIP
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ENTERPRISE PL
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-8202
Mailing Address - Country:US
Mailing Address - Phone:302-678-3353
Mailing Address - Fax:302-678-9245
Practice Address - Street 1:100 ENTERPRISE PL
Practice Address - Street 2:SUITE 1
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-8202
Practice Address - Country:US
Practice Address - Phone:302-678-3353
Practice Address - Fax:302-678-9245
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist