Individual
BLAKE FORREST KLEPAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
30 ARDISIA LN, SAINT JOHNS, FL 32259-3881
(904) 376-3800
Mailing address
PO BOX 748519, ATLANTA, GA 30374-8519
(904) 376-3800
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH22337
FL
106S00000X
Behavior Technician
RBT-17-45567
FL
Other
Enumeration date
12/12/2017
Last updated
11/18/2024
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