Individual
ANDREA BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
17 WOODCHUCK LN, WILTON, CT 06897-3427
(347) 604-4574
Mailing address
17 WOODCHUCK LN, WILTON, CT 06897-3427
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5513
CT
Other
Enumeration date
09/21/2020
Last updated
09/21/2020
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