Jacqueline Margaret Blake, MA, LPC, LLP

NPI #1386799070 in Pontiac, Michigan

Provider Information

NPI Number: 1386799070
Entity Type: Individual
Name: Jacqueline Margaret Blake, MA, LPC, LLP
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Psychologist
Credential: MA, LPC, LLP
Enumeration Date: Jan 24, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 114 ORCHARD LAKE RD
City: Pontiac
State: Michigan
ZIP Code: 48341-2244
Phone: (248) 858-7766

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist	103T00000X	Primary

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