Individual
CARLA BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
425 W 5TH ST, EAST LIVERPOOL, OH 43920-2498
(304) 479-0633
Mailing address
427 LOUISIANA AVE, CHESTER, WV 26034-1234
(304) 479-0633
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA.03877
OH
Other
Enumeration date
02/19/2014
Last updated
11/13/2023
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