Individual
MS. JANIE KATHERINE BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SOCIAL WORKER
Contact information
Practice address
4431 DAVIE ROAD AKA 64TH AVENUE, SUITE 105, DAVIE, FL 33314-3458
(954) 788-2355
(954) 781-3551
Mailing address
2601 NE 15TH STREET, POMPANO BEACH, FL 33062-8253
(954) 788-2355
(954) 781-3551
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
SW599
FL
104100000X
Social Worker
Primary
SW599
FL
Other
Enumeration date
05/21/2008
Last updated
05/21/2008
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