Individual
ADARA BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP, IBCLC
Contact information
Practice address
1337 HOWE AVE, #107, SACRAMENTO, CA 95825
(916) 564-5010
Mailing address
1337 HOWE AVE, #107, SACRAMENTO, CA 95825
(916) 564-5010
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
SL012400
PA
235Z00000X
Speech-Language Pathologist
Primary
SP 25339
CA
Other
Enumeration date
06/15/2015
Last updated
04/20/2017
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