Blaklie Blevins, M.S., CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Attalla, AL
NPI 1124212436 · NPPES record last updated May 1, 2023
Key facts
- NPI
- 1124212436
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 2187 (AL)
- Practice address
- 760 Littleton Rd
Attalla, AL 35954-6385 - Phone
- (256) 239-0108
- NPI assigned
- Aug 29, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2187 | AL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| T.E.a.M. for Kids, LLC | Speech-Language Pathologist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2187 | AL | Yes |
Addresses
Primary practice location
760 Littleton Rd
Attalla, AL 35954-6385
Mailing address
310 Koa Rd
Riverside, AL 35135-1006
Phone (256) 239-0108
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 890022130 | Medicaid | AL |
Other providers in Attalla, AL
- Attalla Nursing Adk, LLC
- Joanna Bazemore
- Ricky Bearden
- Bryan C Beeman
- Renee Michelle Bellew
- Kathy Bowen
- Ashley Bradford
- Breakthrough Beginnings, LLC.
- Jason Paul Burgess
- C.R. of Attalla, LLC
All providers in Attalla, AL · Speech-Language Pathologist in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 1, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.