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1285243436
BRENDA REBECCA BLAKE
SALEM, OR
NPI
1285243436
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Additional Taxonomies
171M00000X Case Manager/Care Coordinator
Enumeration Date
2020-07-23
Last Update Date
2022-06-23
Business Address
BRENDA REBECCA BLAKE
3876 BEVERLY AVE NE BLDG G
SALEM, OR 97305-1319
Phone number: 503-763-5734
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Mailing Address
BRENDA REBECCA BLAKE
3867 WOLVERINE ST NE BLDG F
SALEM, OR 97305-4266
Phone number: 503-763-5734
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