Individual
KENDALL BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1778 CENTURY BLVD NE STE A, ATLANTA, GA 30345-3398
(202) 352-5891
Mailing address
1778 CENTURY BLVD NE STE A, ATLANTA, GA 30345-3398
(202) 352-5891
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW007008
GA
Other
Enumeration date
06/24/2021
Last updated
06/24/2021
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