Individual
BLAKE WILLIAM BARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAPSW
Contact information
Practice address
1015 GAMMON LN, MADISON, WI 53719-2210
(608) 417-8144
Mailing address
428 W WILSON ST, MADISON, WI 53703-3614
(920) 253-9204
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
132878-121
WI
Other
Enumeration date
08/30/2022
Last updated
08/30/2022
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