Most Relevant Information
Provider Data
| NPI Number: | 1003197245 |
| Provider Name: | LYNEAH R BLAKE-DUNCAN TLLP |
| Entity Type: | Individual |
| Taxonomy Code: | 103TB0200X |
| Specialty: | Psychologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/01/2011 |
| Last Updated: | 10/18/2018 |
Provider Practice Location
229 N SHELDON RD
PLYMOUTH
MI
48170
Practice Location Phone/Fax
| Phone: | 3132784601 |
| Fax: |
Provider Mailing Location
229 N SHELDON RD
PLYMOUTH
MI
481701524
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |