LANCE BLAKE

WEST COVINA, CA
NPI1053002451
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2023-05-17
Last Update Date2023-05-17
Business Address
LANCE BLAKE
4141 S NOGALES ST UNIT A104
WEST COVINA, CA 91792-3057
Phone number: 833-831-8946
Mailing Address
LANCE BLAKE
2218 CAMARINA DR
ROWLAND HEIGHTS, CA 91748-3709
Phone number: 626-999-6242
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