Individual
DR. EDDIE LEE BLAKES JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DBH, LIAC
Contact information
Practice address
2266 S DOBSON RD STE 200, MESA, AZ 85202-6412
(480) 521-5289
(480) 386-9910
Mailing address
2266 S DOBSON RD STE 200, MESA, AZ 85202-6412
(480) 521-5289
(480) 386-9910
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LIAC-155298
AZ
101YA0400X
Addiction (Substance Use Disorder) Counselor
LIAC-155298
AZ
101YM0800X
Mental Health Counselor
Primary
LIAC-155298
AZ
Other
Enumeration date
09/18/2020
Last updated
04/29/2025
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