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1578676714
DUDLEY DAVID BLAKE
BOISE, ID
NPI
1578676714
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: ID PSY313)
Enumeration Date
2006-08-15
Last Update Date
2007-07-08
Business Address
Dr. DUDLEY DAVID BLAKE Ph.D.
BOISE VA MEDICAL CENTER 500 WEST FORT STREET
BOISE, ID 83701-4598
Phone number: 208-422-1125
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Mailing Address
Dr. DUDLEY DAVID BLAKE Ph.D.
701 E JEFFERSON ST
BOISE, ID 83712-6413
Phone number: 208-336-0461
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