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1508322330
ALICIA BLAKE
PUEBLO, CO
NPI
1508322330
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2019-02-18
Last Update Date
2019-02-18
Business Address
ALICIA BLAKE
509 E 13TH ST
PUEBLO, CO 81001-2940
Phone number: 719-546-1918
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Mailing Address
ALICIA BLAKE
4485 LAREDO MEADOW PT APT 203
COLORADO SPRINGS, CO 80922-4017
Phone number: 719-246-7340
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