Individual
SHIRLEY D. BLAKELEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
1841 MADORA AVE, DOUGLAS, WY 82633-3057
(307) 358-2846
(307) 358-5329
Mailing address
1841 MADORA AVE, DOUGLAS, WY 82633-3057
(307) 358-2846
(307) 358-5329
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-578
WY
Other
Enumeration date
11/29/2006
Last updated
07/08/2007
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