NPI 1003315615

Amy Jo Blake

Practitioner Behavior Technician Fairfield, VA

Practice location

Address: 1200 Sterrett Rd, Fairfield, VA 24435-2629
Phone: (434) 485-2890
Mailing address: 6528 McGraw Gap Rd, Hot Springs, VA 24445-2522

Registered specialties

Behavior Technician Primary

Behavioral Health & Social Service Providers Taxonomy 106S00000X

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Registry record

NPI: 1003315615
Entity type: Individual
Sex (as registered): Female
NPI issued: 9 Feb 2018
Record last updated: 9 Feb 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.