Individual
DR. KEVIN BLAKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
5955 ZEAMER AVE, ELMENDORF AFB, AK 99506-3702
(907) 580-3114
Mailing address
5955 ZEAMER AVE, ELMENDORF AFB, AK 99506-3702
(907) 580-3114
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
1742
AZ
Other
Enumeration date
03/20/2006
Last updated
02/11/2009
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