Individual
ALICIA BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
509 E 13TH ST, PUEBLO, CO 81001-2940
(719) 546-1918
Mailing address
4485 LAREDO MEADOW PT APT 203, COLORADO SPRINGS, CO 80922-4017
(719) 246-7340
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/18/2019
Last updated
02/18/2019
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