Individual
REBECCA EVE O'DONNELL BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
52 SECOND AVE, WALTHAM, MA 02451-1127
(781) 487-6181
(781) 487-6826
Mailing address
52 SECOND AVE, WALTHAM, MA 02451-1127
(781) 487-6181
(781) 487-6826
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA6527
MA
Other
Enumeration date
05/14/2018
Last updated
09/05/2023
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