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Individual
MR. JORDEN DENEIL BLAKELY
Active
Individual
MR. JORDEN DENEIL BLAKELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OWNER
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
92-0390919
HOMECARE
OH
Enumeration date
11/16/2022
Last updated
04/08/2025
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