Search › Pennsylvania › 104100000X
Jonathan Blake, LSW
NPI 1154108439 · on the registry since 2023 · sole proprietor
Practice
- Address
- 126 Willow Ave
Olyphant, PA 18447 - Phone
- (570) 382-8157
Registry record
- Primary taxonomy
- 104100000X
104100000X
- Licence states on file
- PA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2023-09-11
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Pennsylvania