Individual
BLAKE OVERSTREET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1814 8TH AVE, FORT WORTH, TX 76110-1354
(817) 565-6113
Mailing address
105 VINEYARD ST, WEATHERFORD, TX 76087-7949
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
92524
TX
Other
Enumeration date
03/13/2025
Last updated
03/13/2025
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