Edward Blake Valid NPI
Individual provider · Counselor · Petaluma, CA
- NPI
- 1124435227
- Type
- Individual (Type 1)
- Primary specialty
- Counselor
- Specialty group
- Behavioral Health & Social Service Providers
- Taxonomy code
- 101Y00000X
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2014-07-21
- Last updated
- 2014-07-21
Practice location
365 Kuck Ln
Petaluma, CA 94952-9606
(707) 795-6954