Individual
MS. LYNEAH R BLAKE-DUNCAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
TLLP
Contact information
Practice address
229 N SHELDON RD, PLYMOUTH, MI 48170
(313) 278-4601
Mailing address
229 N SHELDON RD, PLYMOUTH, MI 48170-1524
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
251S00000X
Community/Behavioral Health Agency
6301015236
MI
Other
Enumeration date
09/01/2011
Last updated
10/18/2018
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