Generra Blake

NPI #1902452782 in Blanding, Utah

Provider Information

NPI Number
1902452782
Entity Type
Individual
Name
Generra Blake
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Counselor - Mental Health
Enumeration Date
Aug 16, 2019
Last Updated
Aug 16, 2019

Practice Location

Address
735 S 200 W STE 1
State
Utah
ZIP Code
84511-3923
Phone
(435) 678-2992

Specialties & Taxonomy Codes

Specialty
Counselor - Mental HealthMental Health

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