Individual
MADISON LEIGH BLAYNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.,CF-SLP
Contact information
Practice address
812 S 2ND ST, LOUISVILLE, KY 40203-2275
(502) 873-4223
(502) 333-9743
Mailing address
812 S 2ND ST, LOUISVILLE, KY 40203-2275
(502) 873-4223
(502) 333-9743
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
264796
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
264796
STATE LICENSE
KY
Enumeration date
08/19/2020
Last updated
08/19/2020
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