Blake, Samantha R

Blake, Samantha R is an sole proprietor health care provider with primary practice located at 44235 Galicia Dr , Hemet CA 92544-9125. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as her primary health care specialty. Blake, Samantha R can be contacted via phone (909) 228-0298.

Contact Information

Primary practice address
44235 Galicia Dr Hemet CA 92544-9125
Phone: (909) 228-0298
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 1-17-28663 California

Profile Details

NPI number 1841830155
LBN Legal business name Blake, Samantha R
Credentials BCBA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 14th, 2020
Last updated Jan 14th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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