Individual
MISS ANDRA CONIECE BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MFTI
Contact information
Practice address
1500 S MCDONNELL AVE, COMMERCE, CA 90040-5623
(323) 981-4322
Mailing address
11702 MENLO AVE, APT. #10, HAWTHORNE, CA 90250-2585
(323) 981-4322
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/30/2006
Last updated
07/08/2007
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