Individual
JASON PRINZ BLUME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
750 NW CHARBONNEAU ST., SUITE 201, BEND, OR 97701
(541) 591-5669
Mailing address
750 NW CHARBONNEAU ST, SUITE 201, BEND, OR 97701
(541) 591-5669
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
IN-10208105
OR
Other
Enumeration date
06/08/2020
Last updated
06/08/2020
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