| NPI | 1255657201 |
|---|---|
| Other Name | BLAKE ALTOM |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253J00000X Foster Care Agency |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: UT 7195889-3904) |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2010-04-15 |