Organization
DR BLAKE BAZEL PHD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BLAKE BAZEL PHD (PSYCHOLOGIST)
(904) 272-0043
Entity
Organization
Contact information
Practice address
1677 WELLS RD, SUITE A, ORANGE PARK, FL 32073-6799
(904) 272-0043
Mailing address
1677 WELLS RD, SUITE A, ORANGE PARK, FL 32073-6799
(904) 272-0043
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY 8593
FL
Other
Enumeration date
02/25/2013
Last updated
04/23/2013
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