Individual
DOMINIQUE BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
514 LOVELL AVE APT 7, ROSEVILLE, MN 55113-4654
(651) 315-3480
Mailing address
514 LOVELL AVE APT 7, SAINT PAUL, MN 55113-4654
(651) 315-3480
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
09/15/2025
Last updated
09/15/2025
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