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Individual

MONICA L. BLUME

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW LLC

Contact information

Practice address
1220 N MAIN ST STE 11, SPRINGVILLE, UT 84663-4016
(801) 361-0982
Mailing address
1220 N MAIN ST STE 11, SPRINGVILLE, UT 84663-4016
(801) 361-0982

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
355637-3501
UT
1041C0700X
Clinical Social Worker
Primary
355637-3501
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
271298319
IRS
UT
Enumeration date
03/11/2010
Last updated
12/14/2018
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