Provider Demographics
NPI:1326874322
Name:KING, BELLE (CF SLP)
Entity type:Individual
Prefix:
First Name:BELLE
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:CF SLP
Other - Prefix:
Other - First Name:BELLE
Other - Middle Name:
Other - Last Name:BLACKBURN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:HC 64 BOX 21114
Mailing Address - Street 2:
Mailing Address - City:AXTELL
Mailing Address - State:UT
Mailing Address - Zip Code:84621
Mailing Address - Country:US
Mailing Address - Phone:435-979-3360
Mailing Address - Fax:
Practice Address - Street 1:13 E CENTER ST
Practice Address - Street 2:
Practice Address - City:GUNNISON
Practice Address - State:UT
Practice Address - Zip Code:84643
Practice Address - Country:US
Practice Address - Phone:435-274-3532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist