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NPI Profile for KIMBERLEY BLAKE in BRIDGEPORT, CT.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X |
| NPI Number | 1922771765 |
|
| Status | Active | |
| Credentials | MA, NCC, LPC | |
| Entity | Individual | |
| Enumeration date | 07/28/2021 | |
| Last updated | 07/28/2021 - About 5 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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KIMBERLEY BLAKE
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KIMBERLEY BLAKE, MA, NCC, LPC