Individual
MS. ELIZABETH ANNE BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2711 PINEDALE RD STE A, GREENSBORO, NC 27408-4706
(336) 540-9400
(336) 540-9454
Mailing address
2711 PINEDALE RD STE A, GREENSBORO, NC 27408-4706
(336) 540-9400
(336) 540-9454
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2982
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6102403
—
NC
Enumeration date
08/28/2006
Last updated
07/08/2007
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