Individual
BLAKE GIMBEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
700 CHILDRENS DR, COLUMBUS, OH 43205-2639
(614) 722-4700
(614) 722-4718
Mailing address
700 CHILDRENS DR, COLUMBUS, OH 43205-2639
(614) 722-2000
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
P.08718
OH
103TC2200X
Clinical Child & Adolescent Psychologist
P.08718
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0080896
—
OH
Enumeration date
08/03/2016
Last updated
04/10/2025
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