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Individual
JASON BLACKLEDGE
Active
Individual
JASON BLACKLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CIT
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CIT-5595
LA
Other
Enumeration date
09/12/2023
Last updated
09/12/2023
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