Individual
BLAKE CAROL ANN HARBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
969 BROADWAY, OAKLAND, CA 94607-4017
(510) 251-3962
(510) 251-3954
Mailing address
969 BROADWAY, OAKLAND, CA 94607-4017
(510) 251-3962
(510) 251-3954
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
68349
CA
101YM0800X
Mental Health Counselor
68349
CA
Other
Enumeration date
05/19/2009
Last updated
04/12/2016
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