Provider Demographics
NPI:1033973441
Name:BLAKE-SMITH, PATRICIA (MSPH)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:BLAKE-SMITH
Suffix:
Gender:F
Credentials:MSPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6720 N FARMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-2882
Mailing Address - Country:US
Mailing Address - Phone:313-475-5690
Mailing Address - Fax:
Practice Address - Street 1:115 ERSKINE ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2776
Practice Address - Country:US
Practice Address - Phone:313-518-2627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker