Individual
MRS. GLORIA CLEMENCIA BLAKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA-CMHC-CABA
Contact information
Practice address
315 N LAKEMONT AVE STE B, WINTER PARK, FL 32792-3205
(407) 830-6412
(407) 830-8413
Mailing address
8595 TANSY DR, ORLANDO, FL 32819-4512
(321) 442-6683
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCC05002
FL
Other
Enumeration date
09/28/2010
Last updated
09/28/2010
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