Individual
MR. KEVIN LEE BOBLITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LMHC
Contact information
Practice address
601 WALL ST, VALPARAISO, IN 46383-2512
(219) 531-3500
Mailing address
1209 W 21ST ST, LAPORTE, IN 46350-6471
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39001569A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000316976
ANTHEM
IN
Enumeration date
10/04/2005
Last updated
07/08/2007
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