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Individual

BLAKE EVAN GILBO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.S., LPC

Contact information

Practice address
908 CRESCENT DR APT 1-1, CHAMPAIGN, IL 61821-4270
(217) 974-9091
(217) 974-9091
Mailing address
206 W MARVIN AVE, FREDERICKTOWN, MO 63645-1648
(573) 783-9248

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2015041412
MO
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
06/06/2012
Last updated
04/29/2026
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