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Katherine Anne Blake
Student in an Organized Health Care Education/Training Program in Dallas, Georgia
NPI 1205691763

Katherine Anne Blake is a Student in an Organized Health Care Education/Training Program based in Dallas, GA. Katherine Anne Blake practices in Dallas, GA. The NPI Number for Katherine Anne Blake is 1205691763 and holds a License No. (Georgia).

The current practice location address for Katherine Anne Blake is 393 Valor Ridge Dr, Dallas, GA and can be reached out via phone at 404-542-8138.

Location: 393 Valor Ridge Dr, Dallas, GA, 30132-2382
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1205691763
Provider Name
Katherine Anne Blake
Credential
Provider Entity Type
Individual
Gender
Female
Address
393 Valor Ridge Dr, Dallas, GA, 30132-2382
Phone Number
404-542-8138
Fax Number
Provider Enumeration Date
02/14/2024
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
393 Valor Ridge Dr
City
Dallas
State
Georgia
Zip
30132-2382
Phone Number
404-542-8138
Fax Number
person
Provider Business Mailing Address Details
Address
393 Valor Ridge Dr
City
Dallas
State
Georgia
Zip
30132-2382
Phone Number
404-542-8138
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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