Samantha Dawn Blake

NPI #1275091852 in Saint Clairsville, Ohio

Provider Information

NPI Number: 1275091852
Entity Type: Individual
Name: Samantha Dawn Blake
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Mar 4, 2019
Last Updated: Mar 4, 2019

Practice Location

Address: 1 HALLORAN PARK LN
City: Saint Clairsville
State: Ohio
ZIP Code: 43950-1367
Phone: (740) 296-5734

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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