Organization
JANICE BLAKE APRN, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE BLAKE PMHNP-BC (OWNER/OPERATOR)
(860) 266-7826
Entity
Organization
Contact information
Practice address
181 THOMPSON ST, S GLASTONBURY, CT 06073-2919
(860) 266-7826
Mailing address
181 THOMPSON ST, S GLASTONBURY, CT 06073-2919
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/14/2021
Last updated
06/15/2021
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