Individual
BLAKE PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
271 FINCH AVE, MERIDEN, CT 06451-2715
(203) 237-8084
(203) 639-1333
Mailing address
271 FINCH AVE, MERIDEN, CT 06451-2715
(203) 237-8084
(203) 639-1333
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1598
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004160941
—
CT
Enumeration date
06/17/2013
Last updated
06/17/2013
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