Individual
ERIN MICHELLE BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4727 BRADLEY ROAD, HUNTINGTON, WV 25704-1812
(304) 633-6343
Mailing address
4727 BRADLEY ROAD, HUNTINGTON, WV 25704
(304) 633-6343
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
WV
Other
Enumeration date
10/07/2024
Last updated
10/07/2024
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