Individual
DOREEN BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, CDC1
Contact information
Practice address
733 2ND AVENUE, KOTZEBUE, AK 99752-1453
(907) 442-7640
(907) 442-7749
Mailing address
PO BOX 256, KOTZEBUE, AK 99752-0256
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
153055
AK
Other
Enumeration date
04/27/2017
Last updated
03/12/2020
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