Individual
SHAKEYA TYNEICE BLAKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 ENTERPRISE DR STE 415, SHELTON, CT 06484-4631
(203) 255-5078
(203) 295-7663
Mailing address
26 CRESCENT ST, ANSONIA, CT 06401-2161
(203) 400-7304
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
00000000000
CT
Other
Enumeration date
10/23/2024
Last updated
10/23/2024
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