Mistey Blake, MA TLLP CADC-M

NPI 1821330499 · on the registry since 2013

Practice

Address: 50430 School House Rd
100
Canton, MI 48187
Phone: (734) 495-1722
Fax: (734) 495-3068
Organisation at this address: Family Service Of Detroit & Wayne County
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 51

Registry record

Primary taxonomy: 103TC0700X
103TC0700X
Licence states on file: MI
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2013-03-21

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 Michigan