LISA JOLENE BLAKE

RIVERDALE, UT
NPI1376177584
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: UT  6306212-3501)
Enumeration Date2020-02-26
Last Update Date2023-03-05
Business Address
LISA JOLENE BLAKE
4933 S 1500 W STE 200
RIVERDALE, UT 84405-7738
Phone number: 385-427-1072
Mailing Address
LISA JOLENE BLAKE
1314 24TH ST
OGDEN, UT 84401-2902
Phone number: 801-695-5057