Individual
JACKLYN MICHELE BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC, MBA
Contact information
Practice address
600 NEW WAVERLY PL STE 100, CARY, NC 27518-7404
(984) 268-6710
Mailing address
600 NEW WAVERLY PL STE 100, CARY, NC 27518-7404
(919) 889-4448
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
15965
NC
Other
Enumeration date
08/13/2016
Last updated
03/04/2025
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