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1942800339
JACKLENE NICOLE BLAKE
HUNTINGTON, WV
NPI
1942800339
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
3747P1801X Technician Personal Care Attendant
Enumeration Date
2020-10-27
Last Update Date
2020-10-27
Business Address
JACKLENE NICOLE BLAKE
1914 WASHINGTON AVE
HUNTINGTON, WV 25704-1443
Phone number: 304-360-0100
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Mailing Address
JACKLENE NICOLE BLAKE
1914 WASHINGTON AVE
HUNTINGTON, WV 25704-1443
Phone number: 304-360-0100
Copy
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