Individual
DEREK BLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSAC
Contact information
Practice address
5900 MONONA DR STE 300, MONONA, WI 53716-3561
(608) 977-0872
Mailing address
5900 MONONA DR STE 300, MONONA, WI 53716-3561
(608) 977-0872
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
03/31/2025
Last updated
03/31/2025
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