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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DAKOTA STORM BLAKE, PTA

Active

DAKOTA STORM BLAKE, PTA is a Occupational Therapist healthcare provider located in FORT EDWARD, New York. NPI 1417594748 is currently active in the NPPES registry. Verify at CMS.

Occupational Therapist · FORT EDWARD, NY

Registration Details

NPI Number
1417594748
Provider Type
Individual
Gender
Male
NPI Issued
Dec 5, 2019 (6.6560602591565 yrs)
Last Updated
Dec 5, 2019
License
012276-01 (NY)

Practice Information

Address
319 BROADWAY
FORT EDWARD, NY, 128281221
Browse NY providers · Browse ZIP 12828
Phone
5187460700
Primary Specialty
Occupational Therapist
225200000X

Other Occupational Therapist Providers in FORT EDWARD, NY

Name Credential NPI
KYLE STREETER 1790347086
TARYN E ASHE PTA 1972195261
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.