Individual
MELINDA A BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APSW
Contact information
Practice address
4650 S HOWELL AVE, MILWAUKEE, WI 53207-5908
(414) 376-5577
(414) 762-9927
Mailing address
217 WISCONSIN AVE STE 204, WAUKESHA, WI 53186-4946
(414) 301-6384
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
18503
WI
1041C0700X
Clinical Social Worker
Primary
131843
WI
Other
Enumeration date
07/12/2022
Last updated
07/12/2022
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