Individual
BLAYNE ALLYSSA BOGARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3235 OLIVET CHURCH RD STE D, PADUCAH, KY 42001-9545
(270) 443-5712
(270) 933-1095
Mailing address
3235 OLIVET CHURCH RD STE D, PADUCAH, KY 42001-9545
(270) 443-5712
(270) 933-1095
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
299540
KY
Other
Enumeration date
06/19/2025
Last updated
06/19/2025
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