Individual
DR. DANIEL BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
26789 WOODWARD AVE, HUNTINGTON WOODS, MI 48070-1335
(248) 398-3693
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1865
(947) 522-0307
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301005841
MI
Other
Enumeration date
06/16/2006
Last updated
07/22/2022
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