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Contact Information

GEOFFREY BLAKE
24682 CHANTILLY LN
DAPHNE, AL36526-8730
 Phone: 251-591-4740
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pastoral

101YP1600X
Indicates primary specialty

NPI Profile & details for GEOFFREY BLAKE · (Male)

NPI # 1730710591
Status Active
Credentials
Entity Individual
Enumeration date 01/30/2020
Last updated 01/30/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • AL License # 17802
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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