Individual
MELISSA A BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
3257 WHITFIELD CT, WATERFORD, MI 48329
(248) 412-3826
Mailing address
3257 WHITFIELD CT, WATERFORD, MI 48329-2769
(248) 412-3826
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201007148
MI
Other
Enumeration date
08/20/2018
Last updated
08/21/2018
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