Timothy Carl Blake
NPI #1003044066 in Winston Salem, North Carolina
Provider Information
- NPI Number
- 1003044066
- Entity Type
- Individual
- Name
- Timothy Carl Blake
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor
- Enumeration Date
- Jun 29, 2009
- Last Updated
- Jun 29, 2009
Practice Location
- Address
- 725 HIGHLAND AVE
- City
- Winston Salem
- State
- North Carolina
- ZIP Code
- 27101-4206
- Phone
- (336) 607-8523
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor |
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