NPI 1639626294 · live from the CMS NPI Registry
Kai Bergondi Blake, M.Ed
Psychologist, School in Washington, DC. National Provider Identifier 1639626294, active.
NPI record
| NPI | 1639626294 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychologist, School 103TS0200X |
| Practice location | 1919 15th St Se, Washington, DC 20020 |
| Practice phone | 240-412-8260 |
| Mailing address | 7800 Pomfret Rd, Pomfret, MD 20675 |
| Enumerated | September 1, 2016 |
| Last updated | September 1, 2016 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist, School primary | 103TS0200X | 10993888 (DC) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.