Blake, Timothy G
Blake, Timothy G is an sole proprietor health care provider with primary practice located at 2649 Park Ave , Minneapolis MN 55407-1006. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Blake, Timothy G can be contacted via phone (612) 676-1604.Contact Information
Primary practice address
2649 Park Ave
Minneapolis MN 55407-1006
Phone: (612) 676-1604
Fax: (612) 379-8235
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 5115 | Minnesota |
Profile Details
| NPI number | 1568796613 |
|---|---|
| LBN Legal business name | Blake, Timothy G |
| Credentials | LP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 22nd, 2009 |
| Last updated | Mar 11th, 2021 - 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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