Individual provider · Type 1 NPI

Christopher Blake Glaze

Professional Counselor · Lagrange, GA

NPI number 1104464296 Active

Practice location

122 Gordon Commercial Dr Ste C
Lagrange, GA 30240-5754

Call (706) 845-4045 Map

Mailing address

709 S 12th St
Lanett, AL 36863-2831

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500XNone listed

Professional Counselor: Definition to come...

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About NPI 1104464296

Christopher Blake Glaze's National Provider Identifier is 1104464296, issued on Dec 19, 2019. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Lagrange, GA. The record was last updated on Dec 19, 2019.