Individual
JANICE BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
141 MAIN ST, SPENCER, WV 25276-1414
(304) 927-5262
(304) 927-0378
Mailing address
141 MAIN ST, SPENCER, WV 25276-1414
(304) 927-5262
(304) 927-0378
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
922
WV
Other
Enumeration date
01/25/2007
Last updated
07/08/2007
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