Individual
BLAINE ALLISTAIR LAKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4803 S 7TH ST, TERRE HAUTE, IN 47802-4565
(812) 269-5038
Mailing address
90 HOWARD DR, SHELBYVILLE, KY 40065-8138
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/07/2026
Last updated
01/07/2026
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