Provider Demographics
NPI:1801688874
Name:ALLEY, BLAKE
Entity type:Individual
Prefix:
First Name:BLAKE
Middle Name:
Last Name:ALLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 10TH ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-6348
Mailing Address - Country:US
Mailing Address - Phone:337-532-5264
Mailing Address - Fax:
Practice Address - Street 1:1330 OAKRIDGE DR UNIT 105
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-9651
Practice Address - Country:US
Practice Address - Phone:337-532-5264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist