Individual
MISS KAYLA BLAKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CRC, LPC
Contact information
Practice address
2020 DEMPSTER ST, EVANSTON, IL 60202-1017
(847) 905-0702
Mailing address
515 BUSSE HWY STE 150, PARK RIDGE, IL 60068-3155
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178.016155
IL
Other
Enumeration date
10/29/2020
Last updated
10/29/2020
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