Individual
JOLENE ROSE BLAHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
199 COUNTY ROAD DF FL 3, JUNEAU, WI 53039-9512
(920) 386-3500
(920) 386-4564
Mailing address
590 RIVER RD APT 5, COLUMBUS, WI 53925-1722
(920) 350-2866
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
103481-121
WI
1041C0700X
Clinical Social Worker
Primary
12857-123
WI
Other
Enumeration date
06/21/2024
Last updated
04/10/2026
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