| Christopher Blake, MACCCSLP | |
|
2795 Pilot Knob Rd, Suite #100, Eagan, MN 55121-1119 | |
| (651) 994-9644 | |
| (651) 994-8962 |
| Full Name | Christopher Blake |
|---|---|
| Gender | Male |
| Speciality | Speech-language Pathologist |
| Location | 2795 Pilot Knob Rd, Eagan, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831238591 | NPI | - | NPPES |
| 962S9BL | Other | MN | BCBS |
| HP32576 | Other | MN | HEALTH PARTNERS |
| 4600244 | Other | MN | MEDICA |
| 442612600 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | 6349 (Minnesota) | Primary |
| Provider Name | Childrens Therapy Center Inc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1295809366 PECOS PAC ID: 8426358854 Enrollment ID: O20151207003001 |
| Mailing Address | Practice Location Address |
|---|---|
| Christopher Blake, MACCCSLP 4058 Deerwood Trl, Eagan, MN 55122-1889 Ph: (651) 994-9644 | Christopher Blake, MACCCSLP 2795 Pilot Knob Rd, Suite #100, Eagan, MN 55121-1119 Ph: (651) 994-9644 |
Shirin Razavian, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2030 Rahn Way, Eagan, MN 55122 Phone: 651-529-1960 | |
Claudia Christensen-major, MACCCSLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 2795 Pilot Knob Rd, Suite 100, Eagan, MN 55121 Phone: 651-994-9644 Fax: 651-994-8962 | |
Kelly Carlson, MACCCSLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2795 Pilot Knob Rd, Suite 100, Eagan, MN 55121 Phone: 651-994-9644 Fax: 651-994-8962 | |
Jennifer Bailey, MACCCSLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2795 Pilot Knob Rd, Suite #100, Eagan, MN 55121 Phone: 651-994-9644 Fax: 651-994-8962 | |
Katlyn Elizabeth Dahlstrom, SLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 3305 Central Park Village Dr Ste 130, Eagan, MN 55121 Phone: 651-406-8868 | |
Amanda Enstrom, M.A., CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 3464 Washington Dr, Suite 110, Eagan, MN 55122 Phone: 952-460-4278 | |
Kelsey Falligant, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2795 Pilot Knob Rd Ste 100, Eagan, MN 55121 Phone: 651-994-9644 |