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Individual

DANA J BLAKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ACSW

Contact information

Practice address
3960 PATIENT CARE WAY, SUITE 101, LANSING, MI 48911-4275
(517) 882-3732
(517) 882-3633
Mailing address
PO BOX 10, MASON, MI 48854-0010
(517) 676-9788
(517) 676-3438

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801064925
MI

Other

Enumeration date
08/14/2006
Last updated
07/08/2007
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