NICHOLAS GLENN BLAKE

BOSTON, MA
NPI1437076346
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2026-07-01
Last Update Date2026-07-01
Business Address
NICHOLAS GLENN BLAKE
23 BRADSTON ST
BOSTON, MA 02118-2703
Phone number: 617-318-6488
Mailing Address
NICHOLAS GLENN BLAKE
23 BRADSTON ST
BOSTON, MA 02118-2703
Phone number: 617-318-6488