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Individual

DR. BLAKE EVAN KIRSCHNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
299 ORANGE RD, FLOOR 1, MONTCLAIR, NJ 07042-4420
(503) 933-9837
Mailing address
299 ORANGE RD, FLOOR 1, MONTCLAIR, NJ 07042-4420
(503) 933-9837

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
35SI00554300
NJ
103TC2200X
Clinical Child & Adolescent Psychologist
35SI00554300
NJ

Other

Enumeration date
09/20/2010
Last updated
12/19/2015
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