Individual
MR. BLAKE HAMILTON CLEMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCA
Contact information
Practice address
2124 CROWN CENTRE DR, SUITE 400, CHARLOTTE, NC 28227-7803
(704) 849-0144
Mailing address
2124 CROWN CENTRE DR, SUITE 400, CHARLOTTE, NC 28227-7803
(704) 849-0144
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
A12043
NC
Other
Enumeration date
02/16/2016
Last updated
02/16/2016
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