Individual
BLAKE KENNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-5000
Mailing address
6133 BYRAM LAKE DR, LINDEN, MI 48451-8741
(810) 444-0613
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201010232
MI
Other
Enumeration date
10/14/2019
Last updated
10/14/2019
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