Individual
GABRIELLE BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
100 SUPERIOR ST, NEWTON FALLS, OH 44444-1745
(330) 953-0243
Mailing address
7939 CASTLE ROCK DR NE, WARREN, OH 44484-1412
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
C.2103079
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.171613
OH
101YP2500X
Professional Counselor
Primary
C.2103079
OH
Other
Enumeration date
02/07/2020
Last updated
02/02/2021
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