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Individual

MR. CHRISTOPHER V BLAKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
64 ROBBINS ST, WATERBURY HOSPITAL CRISIS CENTER, WATERBURY, CT 06708-2613
(203) 573-6103
(203) 573-7240
Mailing address
64 ROBBINS ST, WATERBURY HOSPITAL CRISIS CENTER, WATERBURY, CT 06708-2613
(203) 573-6103
(203) 573-7240

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
002120
CT

Other

Enumeration date
12/19/2011
Last updated
12/19/2011
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