Individual
MR. BLAKE GIOVANNI SOULET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LLC
Contact information
Practice address
6960 ORCHARD LAKE RD STE 202, WEST BLOOMFIELD, MI 48322-4519
(248) 985-9942
(248) 221-1775
Mailing address
5384 BENTLEY RD APT 106, WEST BLOOMFIELD, MI 48322-2189
(248) 736-7541
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6451023525
MI
Other
Enumeration date
02/19/2024
Last updated
02/19/2024
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