Individual
TERALD BLAKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
308 E 21ST AVE, GARY, IN 46407-2618
(219) 886-1320
(219) 886-1319
Mailing address
308 E 21ST AVE, GARY, IN 46407-2618
(219) 886-1320
(219) 886-1319
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
06/15/2007
Last updated
07/08/2007
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