Individual
MRS. JESSICA ASHLEY BLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
820 PARK DR, STE GENEVIEVE, MO 63670-1566
(573) 883-7407
(573) 883-7537
Mailing address
820 PARK DR, STE GENEVIEVE, MO 63670-1566
(573) 883-7407
(573) 883-7537
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2018012458
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490053268
—
MO
Enumeration date
04/26/2018
Last updated
03/30/2020
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