Individual
JILL K BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSCSW
Contact information
Practice address
3601 SW 29TH ST, TOPEKA, KS 66614-2078
(785) 422-8044
Mailing address
3601 SW 29TH ST, TOPEKA, KS 66614-2078
(785) 422-8044
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
7270
KS
1041C0700X
Clinical Social Worker
Primary
4907
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200751030A
—
KS
Enumeration date
01/05/2012
Last updated
02/26/2021
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