Individual
JAMIE BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
3985 STEVE REYNOLDS BLVD BLDG G, NORCROSS, GA 30093-3001
(770) 622-2532
(770) 622-2534
Mailing address
3985 STEVE REYNOLDS BLVD BLDG G, NORCROSS, GA 30093-3001
(770) 622-2532
(770) 622-2534
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
01/10/2012
Last updated
01/10/2012
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