Individual
ANEQUA BLAKELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
6505 216TH ST SW STE 100, MOUNTLAKE TERRACE, WA 98043-2089
(425) 640-7009
Mailing address
100 N HOWARD ST STE W, SPOKANE, WA 99201-0508
(512) 213-0110
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MC61476232
WA
101YP2500X
Professional Counselor
—
IL
101YP2500X
Professional Counselor
—
TX
103K00000X
Behavior Analyst
—
IL
103K00000X
Behavior Analyst
—
TX
Other
Enumeration date
02/06/2023
Last updated
08/18/2023
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