Provider Demographics
NPI:1295016046
Name:BLAKE, ASHLEY PRIOLA
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:PRIOLA
Last Name:BLAKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:PRIOLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2104 HEARTHWOOD LN
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-3152
Mailing Address - Country:US
Mailing Address - Phone:205-529-6804
Mailing Address - Fax:
Practice Address - Street 1:1200 CORPORATE DR STE 125
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35242-5447
Practice Address - Country:US
Practice Address - Phone:205-529-6804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-07
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist