Individual
MR. ANATHALEO BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.A.
Contact information
Practice address
3584 JEROME AVE, BRONX, NY 10467-1006
(718) 653-1537
(718) 228-6993
Mailing address
79 GLENRIDGE RD, GLENVILLE, NY 12302-4523
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
38640-T
NY
104100000X
Social Worker
—
—
Other
Enumeration date
11/17/2014
Last updated
08/21/2024
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