DEREK MICHAEL BLAKE

EUGENE, OR
NPI1982880597
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2008-01-14
Last Update Date2008-01-14
Business Address
Mr. DEREK MICHAEL BLAKE
1790 W 11TH AVE
EUGENE, OR 97402-3758
Phone number: 541-868-0661
Mailing Address
Mr. DEREK MICHAEL BLAKE
1790 W 11TH AVE
EUGENE, OR 97402-3758
Phone number: 541-868-0661
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