| Doctor Name: | LAURA BLAKE |
| NPI Number: | 1013317080 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | LPC 5234 |
| Business Practice Address: | 318 E Maple Ridge Dr Metairie, LA - 700016112 |
| Business Phone Number: | 5042204567 |
| Business Fax Number: | 8883151866 |
| Mailing Address: | 318 E Maple Ridge Dr, METAIRIE |
| State: | LA |
| Postal Code: | 700016112 |
| Phone Number: | 5042204567 |
| Fax Number: | 8883151866 |
| NPI Enumeration Date: | 08/27/2014 |
| NPI Last Update Date: | 08/27/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LPC 5234 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |