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1720813835
LISA BLAKE
BUFFALO, MO
NPI
1720813835
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: MO 2004016764)
Enumeration Date
2024-09-06
Last Update Date
2024-09-06
Business Address
LISA BLAKE
1323 S ASH ST
BUFFALO, MO 65622-9311
Phone number: 417-345-2222
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Mailing Address
LISA BLAKE
65 WEEKS DR
BUFFALO, MO 65622-4116
Phone number: 417-619-4640
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