Individual
MS. BONNIE JEAN BLAKE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MA LMHC ,MHP, GMHS
Contact information
Practice address
221 AVENUE B, SNOHOMISH, WA 98290-2840
(425) 349-7259
Mailing address
330 AVENUE H, SNOHOMISH, WA 98290-2632
(360) 862-1432
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LH00003648
WA
Other
Enumeration date
06/17/2006
Last updated
07/08/2007
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