Mason Blake

NPI #1205526043 in Elko, Nevada

Provider Information

NPI Number: 1205526043
Entity Type: Individual
Name: Mason Blake
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: May 12, 2023
Last Updated: May 12, 2023

Practice Location

Address: 850 ELM ST
City: Elko
State: Nevada
ZIP Code: 89801-3349
Phone: (775) 738-5196

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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