Individual
MS. BARBRA BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
227 DALLAS CT, RIDGWAY, CO 81432
(970) 318-1441
Mailing address
18829 6495 RD, MONTROSE, CO 81403-6700
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
989008
CO
Other
Enumeration date
01/09/2007
Last updated
08/03/2018
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