Individual
MARY BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
116 CARR ST, CLAY, WV 25043-9403
(304) 541-2914
Mailing address
116 CARR ST, CLAY, WV 25043-9403
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
04/11/2025
Last updated
04/11/2025
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