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Individual

AIMEE JEAN BLAKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
401 LAMBERT RD, BISCOE, NC 27209-9002
(910) 428-2117
Mailing address
4478 FORK RD, NORWOOD, NC 28128-8456
(704) 984-2816
(910) 428-1165

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5248
NC

Other

Enumeration date
11/01/2017
Last updated
06/16/2018
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