Individual
BLAKE GLANTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
279 SUMMIT DR, WATERFORD, MI 48328-3364
(248) 745-4900
Mailing address
279 SUMMIT DR, WATERFORD, MI 48328-3364
(248) 745-4900
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
NA
MI
Other
Enumeration date
04/08/2025
Last updated
04/08/2025
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