Individual
MELNA BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
30 S RUBY ST, PHILADELPHIA, PA 19139-3323
(609) 855-1782
Mailing address
30 S RUBY ST, PHILADELPHIA, PA 19139-3323
(609) 855-1782
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/21/2022
Last updated
04/21/2022
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