Individual
CIENNA MICHELLE BLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9000 W SURA LN, GREENFIELD, WI 53228-3477
(414) 246-6800
Mailing address
11621 W BROWN DEER RD APT 10, MILWAUKEE, WI 53224-1440
(414) 699-4624
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6609
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100279349
—
WI
Enumeration date
06/04/2024
Last updated
07/17/2024
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