Individual
LAUREN ELIZABETH BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLMFT
Contact information
Practice address
4769 NORVELL RD, GRASS LAKE, MI 49240-9726
(678) 897-9796
Mailing address
4769 NORVELL RD, GRASS LAKE, MI 49240-9726
(678) 897-9796
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
4151001039
MI
Other
Enumeration date
03/11/2022
Last updated
11/12/2022
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