Individual
YULIYA BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 S CRISMON RD, MESA, AZ 85209-3767
(480) 358-6100
Mailing address
1301 S CRISMON RD, MESA, AZ 85209-3767
(480) 358-6100
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN174617
AZ
Other
Enumeration date
09/23/2016
Last updated
08/11/2021
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