Individual
MS. JOHANNAH BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
2919 E BROADWAY BLVD # 205, TUCSON, AZ 85716-5301
(520) 654-5502
(520) 842-8765
Mailing address
975 N SILVERBELL RD UNIT 85194, TUCSON, AZ 85754-4009
(520) 861-4414
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
229492
AZ
Other
Enumeration date
09/16/2019
Last updated
04/27/2025
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