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Individual

BLAKE LEON MUSGRAVE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
496 S BARTON AVE, FRESNO, CA 93702-2985
(559) 860-4422
Mailing address
496 S BARTON AVE, FRESNO, CA 93702-2985
(559) 860-4422

Taxonomy

Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
CA

Other

Enumeration date
05/06/2026
Last updated
05/06/2026
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