Individual
BLAKLIE BLEVINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
760 LITTLETON RD, ATTALLA, AL 35954-6385
(256) 239-0108
Mailing address
310 KOA RD, RIVERSIDE, AL 35135-1006
(256) 239-0108
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2187
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890022130
—
AL
Enumeration date
08/29/2007
Last updated
05/01/2023
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