Individual
EMILY BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 CEDAR ST, WELLESLEY, MA 02481-3527
(508) 322-0323
Mailing address
24 MORSE ST, WATERTOWN, MA 02472-2556
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-31897
MA
Other
Enumeration date
08/31/2020
Last updated
08/31/2020
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