Individual
LAURENE MARIE BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6665 SECURITY BLVD, WOODLAWN, MD 21207-4018
(410) 265-7291
(410) 265-7294
Mailing address
6665 SECURITY BLVD, WOODLAWN, MD 21207-4018
(410) 265-7291
(410) 265-7294
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
06441
MD
Other
Enumeration date
02/08/2016
Last updated
12/09/2021
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