David Blaine
Peer Specialist in Lorain, OH. Individual provider (NPI-1).
NPI number1942017017
StatusActive
Last updated in NPPESDec 12, 2024
Details
- NPI
- 1942017017
- Entity type
- Individual (NPI-1)
- Name
- David Blaine
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 12, 2024
- Certification date
- Dec 9, 2024
- Last updated
- Dec 12, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 175T00000X | Peer Specialist | APS.000193 | OH | Yes |
Practice location
6140 S BroadwayLorain, OH 44053-3821
Phone 440-233-7232
Mailing address
6140 South BroadwayLorain, OH 44053-3821
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All 64 Peer Specialist providers in Lorain · All 2,400 providers in Lorain
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