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1033848031
MICHAEL SHIELDS BLAKE
BOSTON, MA
NPI
1033848031
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: MA 14466)
Enumeration Date
2022-06-07
Last Update Date
2022-06-07
Business Address
Mr. MICHAEL SHIELDS BLAKE OTR/L
300 LONGWOOD AVE
BOSTON, MA 02115-5724
Phone number: 617-355-7212
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Mailing Address
Mr. MICHAEL SHIELDS BLAKE OTR/L
4894 W 14TH ST
CLEVELAND, OH 44109-5659
Phone number: 440-554-6560
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