Individual
KENNETH BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2470 WRONDEL WAY, SUITE 150B, RENO, NV 89502-3701
(775) 351-2211
(775) 351-2217
Mailing address
3129 MAY ROSE CIR, RENO, NV 89502-7770
(775) 378-1339
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
06/16/2011
Last updated
06/16/2011
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