Individual
MR. ROBERT T BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW-IPR
Contact information
Practice address
4500 S LANCASTER RD, DALLAS, TX 75216-7167
(214) 857-0636
(214) 857-0363
Mailing address
4500 S LANCASTER RD, DALLAS, TX 75216-7167
(214) 857-0363
(214) 857-0363
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
36737
TX
Other
Enumeration date
10/21/2008
Last updated
10/21/2008
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