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1396104527
LORI BLAKE
SPRINGFIELD, OR
NPI
1396104527
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2016-02-16
Last Update Date
2016-10-21
Business Address
LORI BLAKE
2211 CLEAR VUE LN
SPRINGFIELD, OR 97477-1373
Phone number: 541-505-8558
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Mailing Address
LORI BLAKE
3587 HEATHROW WAY
MEDFORD, OR 97504-4004
Phone number: 541-858-8170
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