Individual
JESSE L BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LISW, LCSW
Contact information
Practice address
2000 NOBLE DR, WOOSTER, OH 44691-5353
(330) 264-3232
Mailing address
2000 NOBLE DR, WOOSTER, OH 44691-5353
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
S.1800525-TRNE
OH
104100000X
Social Worker
S.2005362
OH
1041C0700X
Clinical Social Worker
Primary
I.2405108
OH
Other
Enumeration date
10/22/2018
Last updated
08/07/2024
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