Individual
SUSAN BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
52 MISSIONARY RD, CROMWELL, CT 06416-2170
(860) 754-3033
Mailing address
52 MISSIONARY RD, CROMWELL, CT 06416-2170
(860) 754-3033
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
002595
CT
Other
Enumeration date
06/21/2016
Last updated
06/21/2016
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