Individual
MAKALA BLAKELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3603 WASHINGTON BLVD APT 103, INDIANAPOLIS, IN 46205-3572
(219) 257-2732
Mailing address
3603 WASHINGTON BLVD APT 103, INDIANAPOLIS, IN 46205-3572
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/09/2024
Last updated
07/09/2024
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