Individual
MRS. MARLA M BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSW, MA, LSW
Contact information
Practice address
2000 EOFF ST, SUITE 704, WHEELING, WV 26003-3823
(304) 234-8596
Mailing address
2000 EOFF ST, SUITE 704, WHEELING, WV 26003-3823
(304) 234-8596
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
AP02943399
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0115328000
—
WV
Enumeration date
12/06/2010
Last updated
12/06/2010
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