Individual
DR. JAMILIA BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
207 ROCK PRAIRIE RD STE B, CAPSTONE, COLLEGE STATION, TX 77845-8777
(404) 725-2592
(979) 694-7337
Mailing address
PO BOX 12173, COLLEGE STATION, TX 77842-2173
(404) 725-2592
(979) 694-7337
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
36053
TX
Other
Enumeration date
05/23/2012
Last updated
06/12/2012
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