Individual
MARSHA DIANE BLAKELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5130 S PECOS RD STE 2B, LAS VEGAS, NV 89120-1248
(702) 560-5973
(888) 753-3302
Mailing address
5616 GRANDMOTHER HAT ST, N LAS VEGAS, NV 89081-6467
(702) 274-9540
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
IN
Other
Enumeration date
06/28/2015
Last updated
06/28/2015
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