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1275141483
TIANA BLAKE
LOUISBURG, NC
NPI
1275141483
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NC P014861)
Enumeration Date
2020-07-14
Last Update Date
2020-07-14
Business Address
TIANA BLAKE
9033 LAKE ROYALE
LOUISBURG, NC 27549-7208
Phone number: 252-477-0008
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Mailing Address
TIANA BLAKE
127 FILIGREE WAY
DURHAM, NC 27713-5849
Phone number: 929-724-6626
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