Individual
MRS. CYNTHIA E BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1422 SAN MARCO BLVD, JACKSONVILLE, FL 32207-8536
(904) 398-4133
Mailing address
1363 HIGH PLAINS DR W, JACKSONVILLE, FL 32218-7632
(904) 757-1579
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA9678
FL
Other
Enumeration date
05/09/2007
Last updated
07/08/2007
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