Individual
MEKEYA BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3100 STONE BRIDGE TRL SW, CONYERS, GA 30094-6713
(470) 263-6320
Mailing address
3100 STONE BRIDGE TRL SW, CONYERS, GA 30094-6713
(470) 263-7264
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
MSW006768
GA
1041C0700X
Clinical Social Worker
Primary
CSW008047
GA
Other
Enumeration date
09/13/2017
Last updated
11/15/2022
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