Individual
MISS KIELY ANNE BLEVINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2450 ATLANTA HWY STE 701, CUMMING, GA 30040-1255
(470) 632-3412
Mailing address
9910 HIGHTOWER RD, ROSWELL, GA 30075-4107
(336) 509-8990
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
235Z00000X
Speech-Language Pathologist
Primary
SLP012066
GA
Other
Enumeration date
12/17/2018
Last updated
07/15/2022
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