Individual provider · Type 1 NPI

Edward Blake

Counselor · Petaluma, CA

NPI number 1124435227 Active

Practice location

365 Kuck Ln
Petaluma, CA 94952-9606

Call (707) 795-6954 Map

Specialties and licenses

TaxonomyCodeLicense
Counselor Primary 101Y00000XNone listed

Counselor: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

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About NPI 1124435227

Edward Blake's National Provider Identifier is 1124435227, issued on Jul 21, 2014. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Petaluma, CA. The record was last updated on Jul 21, 2014.