Walter B Blake
Counselor, Mental Health in Saint Petersburg, FL. Individual provider (NPI-1).
NPI number1013746031
StatusActive
Last updated in NPPESJul 29, 2024
Details
- NPI
- 1013746031
- Entity type
- Individual (NPI-1)
- Name
- Walter B Blake
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 29, 2024
- Certification date
- Jul 29, 2024
- Last updated
- Jul 29, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | FL | Yes |
Practice location
4024 Central AveSaint Petersburg, FL 33711-1239
Phone 727-327-7656
Mailing address
Po Box 10970Saint Petersburg, FL 33733-0970
Phone 727-327-7656
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