Individual
BLAKE TRAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1809 WILLIAM ST, FREDERICKSBURG, VA 22401-5236
(540) 922-1110
(775) 392-1245
Mailing address
3004 NW 130TH TER APT 353, SUNRISE, FL 33323-3950
(540) 922-1110
(775) 392-1245
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/07/2022
Last updated
07/07/2022
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