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Individual
ORVILLE LIVINGSTONE BLAKE
Active
Individual
ORVILLE LIVINGSTONE BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L, MOT
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
115900
TX
225XN1300X
Neurorehabilitation Occupational Therapist
115900
TX
Other
Enumeration date
03/12/2014
Last updated
03/13/2014
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