Individual
DR. NICOLE BLAKESLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
3264 VAIL PASS DRIVE, COLORADO SPRINGS, CO 80917
(626) 375-3172
Mailing address
3264 VAIL PASS DRIVE, COLORADO SPRINGS, CO 80917
(626) 375-3172
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSYC.00013352
CO
Other
Enumeration date
08/25/2011
Last updated
12/13/2012
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