Individual
DAWN M BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 1/2 OLD RAINER ROAD, ROSEVILLE, OH 43777
(740) 697-0687
Mailing address
229 HIGH ST, ROSEVILLE, OH 43777-1113
(740) 697-0077
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2609878
INDEPENDANT PROVIDER NUMB
OH
Enumeration date
05/03/2007
Last updated
07/08/2007
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