Individual
JENNIFER BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2501 DOWNING ST SW, WILSON, NC 27893-4517
(252) 237-6300
Mailing address
3265 EVERGREEN CIR, WALWORTH, NY 14568-9426
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
07/11/2013
Last updated
07/11/2013
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