Blakeley, Mark Wade

Blakeley, Mark Wade is an sole proprietor health care provider with primary practice located at 17155 Holyoke Court , Parker CO 80134. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional, Emergency Medical Service Providers / Emergency Medical Technician, Paramedic. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Blakeley, Mark Wade can be contacted via phone (303) 601-5761.

Contact Information

Primary practice address
17155 Holyoke Court Parker CO 80134
Phone: (303) 601-5761
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Professional 101YP2500X Colorado
Emergency Medical Service Providers / Emergency Medical Technician, Paramedic 146L00000X Colorado

Profile Details

NPI number 1235307729
LBN Legal business name Blakeley, Mark Wade
Credentials MSC, EMT-P
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 18th, 2008
Last updated Feb 26th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235307729 NPPES
Colorado Other 2791 PARAMEDIC CERTIFICATION

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