Individual
DR. TESSIE BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D., L.P.
Contact information
Practice address
1104 W RIVER RD, DETROIT LAKES, MN 56501-2723
(218) 844-6853
Mailing address
1104 W RIVER RD, DETROIT LAKES, MN 56501-2723
(218) 844-6853
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
04/12/2012
Last updated
02/22/2016
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