Individual
COURTNEY BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 VERMILLION ST, CENTERVILLE, SD 57014-2168
(605) 212-3446
Mailing address
29468 466TH AVE, CENTERVILLE, SD 57014-6308
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
076277
IA
225X00000X
Occupational Therapist
0967
SD
Other
Enumeration date
12/14/2015
Last updated
12/14/2015
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