Provider Information for 1114358199
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Mrs. JAMIE LEE BLAKEMAN LCPC
Sex: Female
NPI: 1114358199
Last Updated: 2022-04-30
Certification Date: 2022-04-30
Certification Date: 2022-04-30
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1114358199 | ||||||||||||
| Enumeration Date | 2013-12-02 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1717 CUDDY DR CHATHAM, IL 62629-6000 United States Phone: 217-779-7496 | Fax: | ||||||||||||
| Primary Practice Address | 2151 W WHITE OAKS DR STE D SPRINGFIELD, IL 62704-6410 United States Phone: 217-779-7496 | Fax: | ||||||||||||
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