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Individual

JOY BLAKESLEE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, WSC

Contact information

Practice address
3100 COLUMBRINA CIR, PORT SAINT LUCIE, FL 34952-3334
(772) 212-5695
(772) 361-6350
Mailing address
3100 COLUMBRINA CIR, PORT SAINT LUCIE, FL 34952-3334
(772) 212-5695
(772) 361-6350

Taxonomy

Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
021924900
FL
Enumeration date
12/27/2017
Last updated
12/27/2017
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