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1720559107
KYLE ANDREW BLAKE
LOS ANGELES, CA
NPI
1720559107
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CA LCSW76408)
Enumeration Date
2018-12-11
Last Update Date
2024-06-13
Business Address
KYLE ANDREW BLAKE LCSW
11500 NIMITZ AVE
LOS ANGELES, CA 90049-3566
Phone number: 424-832-8442
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Mailing Address
KYLE ANDREW BLAKE LCSW
11500 NIMITZ AVE
LOS ANGELES, CA 90049-3566
Phone number: 424-832-8442
Copy
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