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Lance Blake
Mental Health Counselor in West Covina, California
NPI 1053002451

Lance Blake is a Mental Health Counselor based in Rowland Heights, CA and is specialized in Mental Health. Lance Blake practices in West Covina, CA. The NPI Number for Lance Blake is 1053002451 and holds a License No. (California).

The current practice location address for Lance Blake is 4141 S Nogales St Unit A104, West Covina, CA and can be reached out via phone at 833-831-8946.

Location: 4141 S Nogales St Unit A104, West Covina, CA, 91748-3709
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1053002451
Provider Name
Lance Blake
Credential
Provider Entity Type
Individual
Gender
Male
Address
4141 S Nogales St Unit A104, West Covina, CA, 91748-3709
Phone Number
833-831-8946
Fax Number
Provider Enumeration Date
05/17/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
4141 S Nogales St Unit A104
City
West Covina
State
California
Zip
91792-3057
Phone Number
833-831-8946
Fax Number
person
Provider Business Mailing Address Details
Address
4141 S Nogales St Unit A104
City
West Covina
State
California
Zip
91792-3057
Phone Number
833-831-8946
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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