Individual
COURTNEY CHRISTINE BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
758 BROADWAY, ULSTER PARK, NY 12487-5407
(845) 464-7018
Mailing address
758 BROADWAY, ULSTER PARK, NY 12487-5407
(845) 464-7018
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
087122-1
NY
1041S0200X
School Social Worker
Primary
087122-1
NY
Other
Enumeration date
07/24/2019
Last updated
07/24/2019
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