Individual
DR. ROBERT PHILP BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC #C3517
Contact information
Practice address
603 HEMLOCK ST, SUITE 2B, BROOKINGS, OR 97415
(707) 218-1758
Mailing address
P O BOX 175, FORT DICK, CA 95538
(707) 218-1758
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC #C3517
OR
Other
Enumeration date
04/27/2016
Last updated
04/19/2026
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