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1104545003
CARLA MARIE BLAKE
CLARKSBURG, WV
NPI
1104545003
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2022-08-24
Last Update Date
2022-08-24
Business Address
CARLA MARIE BLAKE
311 E PIKE ST
CLARKSBURG, WV 26301-2118
Phone number: 304-627-9754
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Mailing Address
CARLA MARIE BLAKE
311 E PIKE ST
CLARKSBURG, WV 26301-2118
Phone number: 304-627-9754
Copy
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