MISS Jennifer Ann Blake, LSW

NPI #1629623574 in Hines, Illinois

Provider Information

NPI Number: 1629623574
Entity Type: Individual
Name: MISS Jennifer Ann Blake, LSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker
Credential: LSW
Enumeration Date: Aug 7, 2019
Last Updated: Aug 7, 2019

Practice Location

Address: 5000 S 5TH AVE BLDG 200
City: Hines
State: Illinois
ZIP Code: 60141-3030
Phone: (708) 202-5678

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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