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NPI Profile for KING BLAKE in BALTIMORE, MD.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Pastoral |
101YP1600X |
| NPI # | 1730461369 |
|
| Status | Active | |
| Credentials | L.C.P.C. | |
| Entity | Individual | |
| Enumeration date | 09/09/2011 | |
| Last updated | 09/28/2021 - About 5 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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KING BLAKE
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KING BLAKE, L.C.P.C.