Individual
KRISTINE BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, NCC
Contact information
Practice address
3001 PHILADELPHIA PIKE STE 1, CLAYMONT, DE 19703-2580
(844) 222-8500
Mailing address
3001 PHILADELPHIA PIKE STE 1, CLAYMONT, DE 19703-2580
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
PC-0011784
DE
101YP2500X
Professional Counselor
PC-0011784
DE
101YP2500X
Professional Counselor
PC-0011784
—
Other
Enumeration date
12/28/2021
Last updated
04/15/2025
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