Individual
CASSONDRA BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LCPC
Contact information
Practice address
134 N. LASALLE AVE, CHICAGO, IL 60602
(312) 807-0588
Mailing address
134 N. LASALLE AVE, CHICAGO, IL 60602
(312) 807-0588
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180.010348
IL
Other
Enumeration date
10/01/2014
Last updated
08/24/2016
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