| NPI | 1164057303 |
|---|---|
| Former Name | ARLENE DORETTA BLAKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 26209) |
| Enumeration Date | 2020-03-09 |
| Last Update Date | 2020-03-09 |