JEFFREY BLAKE

PORTLAND, ME
NPI1003827239
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: ME  LC9874)
Enumeration Date2006-08-11
Last Update Date2013-03-11
Business Address
-- JEFFREY BLAKE LCSW
22 MONUMENT SQUARE #403
PORTLAND, ME 04101-3914
Phone number: 207-749-9075
Mailing Address
-- JEFFREY BLAKE LCSW
22 MONUMENT SQ #403
PORTLAND, ME 04101-4082
Phone number: 207-749-9075
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