Individual
KIERRA BLASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2210 N ELDORADO AVE, KLAMATH FALLS, OR 97601-6418
(985) 273-9210
Mailing address
2210 N ELDORADO AVE, KLAMATH FALLS, OR 97601-6418
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
LA
Other
Enumeration date
08/09/2022
Last updated
10/17/2023
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