Individual
THOMAS JAMES BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
PHOENIX VA HEALTH CARE SYSTEM, 650 E INDIAN SCHOOL ROAD, PHOENIX, AZ 85012
(602) 277-5551
Mailing address
5016 W SIESTA WAY, LAVEEN, AZ 85339-4232
(602) 799-0424
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
01/09/2020
Last updated
01/09/2020
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