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1912610866
JILLISA YVETTE BLAKE
GAHANNA, OH
NPI
1912610866
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH CDCA.182979)
Enumeration Date
2023-01-05
Last Update Date
2023-01-05
Business Address
JILLISA YVETTE BLAKE CDCA
819 VENETIAN WAY
GAHANNA, OH 43230-1855
Phone number: 614-956-9323
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Mailing Address
JILLISA YVETTE BLAKE CDCA
819 VENETIAN WAY
GAHANNA, OH 43230-1855
Phone number: 614-956-9323
Copy
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