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Organization
LEAF AND STONE PLLC
Active
Organization
LEAF AND STONE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHANNAH BLAKE PMHNP-BC (OWNER/PROVIDER)
(520) 654-5502
Entity
Organization
Contact information
Practice address
2919 E BROADWAY BLVD # 205, TUCSON, AZ 85716-5301
(520) 654-5502
(520) 842-8765
Mailing address
3814 E 5TH ST, TUCSON, AZ 85716-5145
(520) 372-8575
(520) 372-8576
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/01/2023
Last updated
04/27/2025
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