NPI 1598500605

Israel Dennard Blake

Practitioner Religious Nonmedical Practitioner Thomasville, GA

Practice location

Address: 228 Augusta Ave, Thomasville, GA 31792-7003
Phone: (229) 228-7775
Mailing address: PO Box 2763, Thomasville, GA 31799-2763

Registered specialties (2)

Religious Nonmedical Practitioner Primary

Nursing Service Related Providers Taxonomy 374K00000X

Other Religious Nonmedical Practitioner providers in Georgia →

Pastoral Counselor

Behavioral Health & Social Service Providers Taxonomy 101YP1600X

Other Counselor providers in Georgia →

Registry record

NPI: 1598500605
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Jun 2024
Record last updated: 28 Jun 2024

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.