Individual
JOLYNN MARIE BLAKELEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Contact information
Practice address
2115 TRAIL ST, MISSOULA, MT 59801-1537
(406) 491-7450
Mailing address
2115 TRAIL ST, MISSOULA, MT 59801-1537
(406) 491-7450
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
PSY-BA-LIC-5039
MT
Other
Enumeration date
01/07/2025
Last updated
01/07/2025
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