Individual
JENNIFER E BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2900 W PROSPECT RD, FORT LAUDERDALE, FL 33309-2519
(954) 731-1000
Mailing address
4740 N STATE ROAD 7, LAUDERDALE LAKES, FL 33319-5839
(954) 486-4005
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
03/06/2020
Last updated
03/06/2020
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