Individual
ANGELA D BLAKELEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.L.P.C.
Contact information
Practice address
HC 69 BOX 1455, IRONTON, MO 63650-9606
(573) 546-7592
(573) 546-0125
Mailing address
320 S PINE ST, BONNE TERRE, MO 63628-1635
(573) 330-6513
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2007008767
MO
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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