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1548599111
TARA ELISE BLAKE
BRENTWOOD, CA
NPI
1548599111
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: CA 17555)
Enumeration Date
2009-12-10
Last Update Date
2022-01-03
Business Address
-- TARA ELISE BLAKE M.A.
142 PESCARA BLVD
BRENTWOOD, CA 94513-2991
Phone number: 530-518-9991
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Mailing Address
-- TARA ELISE BLAKE M.A.
142 PESCARA BLVD
BRENTWOOD, CA 94513-2991
Phone number: 530-518-9991
Copy
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