Individual
JADE BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 HILLSIDE CIR, WEST SPRINGFIELD, MA 01089-4679
(413) 302-2549
Mailing address
200 HILLSIDE CIR, WEST SPRINGFIELD, MA 01089-4679
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/04/2023
Last updated
08/04/2023
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