Individual
KHADYN BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
318 W 39TH ST FL 5, NEW YORK, NY 10018-1655
(212) 268-5999
Mailing address
318 W 39TH ST FL 5, NEW YORK, NY 10018-1655
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/14/2023
Last updated
11/14/2023
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