Individual
MRS. BLAKE KRISTOL BAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9466 BLACK MOUNTAIN RD STE 100, SAN DIEGO, CA 92126-4550
(858) 689-2027
Mailing address
9466 BLACK MOUNTAIN RD STE 100, SAN DIEGO, CA 92126-4550
(858) 689-2027
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5795
CA
Other
Enumeration date
09/15/2010
Last updated
12/09/2019
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