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1518214899
HAROLD HERBERT BLAKELOCK
PROVO, UT
NPI
1518214899
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TF0200X Psychologist, Forensic
(Licence: UT 114279-2501)
Enumeration Date
2012-08-06
Last Update Date
2012-08-06
Business Address
Dr. HAROLD HERBERT BLAKELOCK
1836 N 1120 W # 2
PROVO, UT 84604-1179
Phone number: 801-722-8362
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Mailing Address
Dr. HAROLD HERBERT BLAKELOCK
1836 N 1120 W # 2
PROVO, UT 84604-1179
Phone number: 801-722-8362
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