TAYLOR L BLAKE

SAN ANTONIO, TX
NPI1265969075
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: TX  12305)
Enumeration Date2017-05-11
Last Update Date2017-05-11
Business Address
-- TAYLOR L BLAKE M.Ed, LCDC
6800 PARK TEN BLVD STE 200S
SAN ANTONIO, TX 78213-4293
Phone number: 210-261-1000
Mailing Address
-- TAYLOR L BLAKE M.Ed, LCDC
6800 PARK TEN BLVD STE 200S ATTN: CREDENTIALING
SAN ANTONIO, TX 78213-4293
Phone number: 210-261-1000
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