Manza Blaine
NPI #1770732539 in Kosciusko, Mississippi
Provider Information
- NPI Number
- 1770732539
- Entity Type
- Individual
- Name
- Manza Blaine
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Speech-Language Pathologist
- Enumeration Date
- Sep 16, 2008
- Last Updated
- Sep 30, 2008
Practice Location
- Address
- 310 AUTUMN RIDGE DR
- City
- Kosciusko
- State
- Mississippi
- ZIP Code
- 39090-3242
- Phone
- (601) 250-4815
Specialties & Taxonomy Codes
| Specialty |
|---|
| Speech-Language Pathologist |
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