Individual
DESTINY BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
345 W 42ND ST, NEW YORK, NY 10036-6982
(212) 257-9677
Mailing address
433 LAFAYETTE AVE APT 18E, BROOKLYN, NY 11238-1433
(347) 827-7889
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/15/2023
Last updated
02/15/2023
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