Individual
ANTHONETTE BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2801 C CT, ASHTABULA, OH 44004-4577
(440) 998-4210
(440) 228-2414
Mailing address
2801 C CT, ASHTABULA, OH 44004-4577
(440) 998-4210
(440) 228-2414
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
OH
101YM0800X
Mental Health Counselor
—
OH
1041C0700X
Clinical Social Worker
Primary
I.2305042
OH
Other
Enumeration date
12/05/2017
Last updated
01/03/2024
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