Individual
DR. JENNIFER SARA BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
500 FOOTHILL BLVD # 119, SALT LAKE CITY, UT 84148-5153
(801) 582-1565
Mailing address
1122 EAGLEWOOD LOOP, NORTH SALT LAKE, UT 84054-3361
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
0202210339
VA
1835P1200X
Pharmacotherapy Pharmacist
Primary
5565622-1701
UT
1835P1200X
Pharmacotherapy Pharmacist
5565622-8911
UT
Other
Enumeration date
09/10/2007
Last updated
05/13/2024
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