Individual
PAMELA BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
2112 S CONGRESS AVE, SUITE 104, PALM SPRINGS, FL 33406-7670
(561) 653-6292
Mailing address
2112 S CONGRESS AVE, SUITE 104, PALM SPRINGS, FL 33406-7670
(561) 653-6292
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
ISW 6007
FL
Other
Enumeration date
11/08/2012
Last updated
11/08/2012
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