Individual
CAITLIN BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CTNC, CHP, CHC, LLC
Contact information
Practice address
220 MAIN ST S STE 207, SOUTHBURY, CT 06488-2275
(860) 491-5059
Mailing address
46 PROSPECT ST, TORRINGTON, CT 06790-6328
(860) 491-5059
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
—
—
Other
Enumeration date
09/19/2018
Last updated
09/19/2018
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