Individual
MS. DONNA H BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYCHOTHERAPIST
Contact information
Practice address
5210 E PIMA ST, SUITE 200, TUCSON, AZ 85712-3664
(520) 795-9313
(520) 777-5768
Mailing address
5210 E PIMA ST, SUITE 200, TUCSON, AZ 85712-3664
(520) 795-9313
(520) 777-5768
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC2202
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124160106
NATIONAL PROVIDER IDENTIFIER
AZ
Enumeration date
02/13/2007
Last updated
04/06/2013
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