Individual
MRS. AMALIA C. BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS.ED
Contact information
Practice address
471 43RD ST, LINDENHURST, NY 11757-2306
(631) 225-7038
Mailing address
471 43RD ST, LINDENHURST, NY 11757-2306
(631) 225-7038
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
09/23/2010
Last updated
09/23/2010
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