Individual
ASHLEY KEITH BLANTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1091 PARK DR STE B, WATKINSVILLE, GA 30677-2014
(706) 546-7550
Mailing address
1540 S LUMPKIN ST APT M228, ATHENS, GA 30605-1532
(912) 381-3179
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC011952
GA
Other
Enumeration date
01/25/2021
Last updated
01/25/2021
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