Individual
MEGHAN BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 N RUFE SNOW DR STE 108D, KELLER, TX 76248-4238
(817) 520-8544
Mailing address
1809 RIVERCHASE LN, JUSTIN, TX 76247-6751
(817) 733-7530
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
89900
TX
106S00000X
Behavior Technician
—
—
Other
Enumeration date
07/31/2019
Last updated
01/09/2026
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