Blake, Shirley R

Blake, Shirley R is an sole proprietor health care provider with primary practice located at 24063 Highpoint Rd , Bristol VA 24202-4707. She recently has 3 registered licenses in different health care specialties including Other Service Providers / Interpreter, Other Service Providers / Specialist, Other Service Providers / Prevention Professional. Other Service Providers / Specialist is her primary health care specialty. Blake, Shirley R can be contacted via phone (276) 971-0079.

Contact Information

Primary practice address
24063 Highpoint Rd Bristol VA 24202-4707
Fax: (276) 591-5353
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Interpreter 171R00000X Virginia
Other Service Providers / Specialist 174400000X PGP-127280 Virginia
Other Service Providers / Prevention Professional 405300000X 10,545 Virginia

Profile Details

NPI number 1467988360
LBN Legal business name Blake, Shirley R
Credentials M.S.
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 11th, 2017
Last updated May 11th, 2017 - about 7 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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