Individual
KAI BERGONDI BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED
Contact information
Practice address
1919 15TH ST SE, WASHINGTON, DC 20020
(240) 412-8260
Mailing address
7800 POMFRET RD, POMFRET, MD 20675-3218
(240) 412-8260
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
10993888
DC
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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