Provider Demographics
NPI:1669646881
Name:BLAKEY, LINDSAY BEAM (CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:BEAM
Last Name:BLAKEY
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 AZALEA AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:GA
Mailing Address - Zip Code:31408-1333
Mailing Address - Country:US
Mailing Address - Phone:912-966-9978
Mailing Address - Fax:
Practice Address - Street 1:137 AZALEA AVE
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:GA
Practice Address - Zip Code:31408-1333
Practice Address - Country:US
Practice Address - Phone:912-966-9978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP006400235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist