Individual
HALEY BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2109 HAMILTON RD STE 217, OKEMOS, MI 48864-1700
(517) 295-3175
Mailing address
5949 SELFRIDGE BLVD, LANSING, MI 48911-4702
(517) 910-3596
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
MI
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
12/20/2019
Last updated
02/06/2026
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