Jeffrey Blake, LCSW

NPI #1003827239 in Portland, Maine

Provider Information

NPI Number
1003827239
Entity Type
Individual
Name
Jeffrey Blake, LCSW
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Social Worker - Clinical
Credential
LCSW
Enumeration Date
Aug 11, 2006
Last Updated
Mar 11, 2013

Practice Location

Address
22 MONUMENT SQUARE
Address 2
#403
State
Maine
ZIP Code
04101-3914
Phone
(207) 749-9075

Specialties & Taxonomy Codes

Specialty
Social Worker - ClinicalClinical

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