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1447601133
JILL BLAKE
SIOUX CITY, IA
NPI
1447601133
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: IA 12122)
Enumeration Date
2016-06-24
Last Update Date
2016-06-24
Business Address
-- JILL BLAKE IADC
3500 W 4TH ST
SIOUX CITY, IA 51103-3203
Phone number: 712-226-1801
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Mailing Address
-- JILL BLAKE IADC
3500 W 4TH ST
SIOUX CITY, IA 51103-3203
Phone number: 712-226-1801
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