National Provider Identifier

Casey Jane Blackburn, M.S., CCC-SLP

Casey Jane Blackburn, M.S., CCC-SLP is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Rochester, NY and a listed phone number of (585) 957-7179.

NPI 1457606212Rochester, NYSpeech-Language Pathologist

Profile Overview

NPI
1457606212
Provider Type
Individual
Primary Specialty
Speech-Language Pathologist
Enumeration Date
July 18, 2012
Last Updated
April 17, 2015

Practice Location

  • 402 Rogers Parkway
  • The Kessler Center
  • Rochester, NY 14617

Phone: (585) 957-7179

Specialties

  • Speech-Language Pathologist (235Z00000X)
  • Speech-Language Pathologist (235Z00000X)
Full Record
NPI
1457606212
Entity Type
Individual
Last Name
Blackburn
First Name
Casey
Middle Name
Jane
Name Prefix
Mrs.
Credential
M.S., CCC-SLP
Provider Other Last Name
Mahler
Provider Other First Name
Casey
Provider Other Middle Name
Jane
Provider Other Credential Text
M.S., CCC-SLP
Provider Other Last Name Type Code
1
Mailing Street Address
402 Rogers Parkway
Mailing Address Line 2
The Kessler Center
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14617
Mailing Country
US
Mailing Phone
(585) 957-7179
Mailing Fax
(585) 924-7049
Practice Street Address
402 Rogers Parkway
Practice Address Line 2
The Kessler Center
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14617
Practice Country
US
Practice Phone
(585) 957-7179
Practice Fax
(585) 924-7049
Enumeration Date
July 18, 2012
Last Updated
April 17, 2015
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Speech-Language Pathologist (235Z00000X), Speech-Language Pathologist (235Z00000X)