Individual
ALLISON MARGARET BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1804 S EDDY ST, GRAND ISLAND, NE 68801-7114
(308) 384-7896
(308) 382-6802
Mailing address
1804 S EDDY ST, GRAND ISLAND, NE 68801-7114
(308) 384-7896
(308) 382-6802
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
470522836
—
NE
Enumeration date
08/12/2016
Last updated
08/12/2016
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