SPENCER THOMAS BLAKE

AMES, IA
NPI1346909991
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: IA  T20064)
Enumeration Date2021-12-10
Last Update Date2021-12-10
Business Address
SPENCER THOMAS BLAKE
804 KELLOGG AVE
AMES, IA 50010-6234
Phone number: 515-233-4930
Mailing Address
SPENCER THOMAS BLAKE
420 KELLOGG AVE
AMES, IA 50010-6226
Phone number: 515-233-3141
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