Individual
JASON BLAKEMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1463 HERITAGE VALLEY DR, HIGH RIDGE, MO 63049-1167
(573) 819-5589
Mailing address
1463 HERITAGE VALLEY DR, HIGH RIDGE, MO 63049-1167
(573) 819-5589
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2014044619
MO
Other
Enumeration date
01/07/2021
Last updated
01/07/2021
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