Individual
MICHELLE DAWN BLAKEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4309 HIGHGATE RD, FORT WORTH, TX 76244-5740
(146) 963-1220
Mailing address
4309 HIGHGATE RD, FORT WORTH, TX 76244-5740
(146) 963-1220
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S.1701354
OH
Other
Enumeration date
09/18/2017
Last updated
04/13/2022
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