Lance Blake

NPI #1053002451 in West Covina, California

Provider Information

NPI Number: 1053002451
Entity Type: Individual
Name: Lance Blake
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Mental Health
Enumeration Date: May 17, 2023
Last Updated: May 17, 2023

Practice Location

Address: 4141 S NOGALES ST UNIT A104
City: West Covina
State: California
ZIP Code: 91792-3057
Phone: (833) 831-8946

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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