Individual
BLAKE KEITHLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S ED.S
Contact information
Practice address
2325 Q ST, BEDFORD, IN 47421-4718
(812) 279-4673
(812) 279-4672
Mailing address
840 W FRANK ST, MITCHELL, IN 47446-1748
(812) 583-5094
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/06/2012
Last updated
03/06/2012
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