NPI | 1265150056 |
---|---|
Other Name | CLAUDETTE L BLAKE PMHNP |
Entity Type | Organization |
Authorized Contact | CLAUDETTE L BLAKE-TONGE Owner 973-704-3756 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Enumeration Date | 2022-08-17 |
Last Update Date | 2022-10-02 |