Provider Demographics
NPI:1477229169
Name:BLAKLEY, ASHLEE MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:MARIE
Last Name:BLAKLEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 LOSOYA DR
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-7094
Mailing Address - Country:US
Mailing Address - Phone:512-923-1658
Mailing Address - Fax:
Practice Address - Street 1:207 LOSOYA DR
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7094
Practice Address - Country:US
Practice Address - Phone:512-923-1658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-21
Last Update Date:2021-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1227705225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist