Otia Blake
Social Worker, Clinical in Baltimore, MD. Individual provider (NPI-1).
NPI number1669944575
StatusActive
Last updated in NPPESOct 18, 2024
Details
- NPI
- 1669944575
- Entity type
- Individual (NPI-1)
- Name
- Otia Blake
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 18, 2018
- Certification date
- Oct 18, 2024
- Last updated
- Oct 18, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 27667 | MD | Yes |
Other names
- Otia T Blake (Professional Name)
Practice location
3030 Greenmount Ave Ste 300Baltimore, MD 21218-6907
Phone 410-978-9770
Mailing address
7911 Freetown RdGlen Burnie, MD 21060-8207
Phone 410-978-9770
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