Lisa Jolene Blake

NPI #1376177584 in Riverdale, Utah

Provider Information

NPI Number
1376177584
Entity Type
Individual
Name
Lisa Jolene Blake
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Social Worker - Clinical
Enumeration Date
Feb 26, 2020
Last Updated
Mar 5, 2023

Practice Location

Address
4933 S 1500 W STE 200
State
Utah
ZIP Code
84405-7738
Phone
(385) 427-1072

Specialties & Taxonomy Codes

Specialty
Social Worker - ClinicalClinical

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