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Individual

MR. BLAKE JOHN LUTZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
2925 LANDON RIDGE DR, NEW HILL, NC 27562-2756
(919) 593-5500
Mailing address
2925 LANDON RIDGE DR, NEW HILL, NC 27562-9305
(919) 593-5500

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
44SC05489300
NJ
1041C0700X
Clinical Social Worker
Primary
C007651
NC

Other

Enumeration date
09/05/2017
Last updated
09/05/2017
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