Individual
MRS. PAM M BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17615 SW 97TH AVE, PALMETTO BAY, FL 33157-5636
(786) 268-2611
(305) 252-2778
Mailing address
17615 SW 97TH AVE, PALMETTO BAY, FL 33157-5636
(786) 268-2611
(305) 252-2778
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
06/26/2009
Last updated
06/26/2009
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