Individual
AMY JO BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 STERRETT RD, FAIRFIELD, VA 24435-2629
(434) 485-2890
Mailing address
6528 MCGRAW GAP RD, HOT SPRINGS, VA 24445-2522
(540) 691-5387
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/09/2018
Last updated
02/09/2018
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