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Individual

MIKE L BLAKEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSY. D

Contact information

Practice address
1400 W. BENSON BLVD STE 315, ANCHORAGE, AK 99503
(907) 929-4009
(907) 929-4902
Mailing address
P.O. BOX 111810, ANCHORAGE, AK 99511
(907) 929-4009
(907) 929-4902

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
113993
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
MH3538
AK
Enumeration date
05/18/2007
Last updated
11/16/2023
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