Individual
BLAINE PAUL BROCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
765 LAKEVIEW DR, WEST JEFFERSON, OH 43162-9587
(614) 296-6391
Mailing address
765 LAKEVIEW DR, WEST JEFFERSON, OH 43162-9587
(614) 296-6391
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
11/24/2021
Last updated
11/24/2021
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