Individual
BLAKE MACKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSS
Contact information
Practice address
123 CHESTNUT ST STE 304, PHILADELPHIA, PA 19106-3059
(215) 399-4128
Mailing address
4112 GRACE VIRGINIA CT, ALLENTOWN, PA 18104-5503
(484) 553-0422
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/10/2025
Last updated
06/10/2025
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