Individual
MR. DEREK BLAGOJEVIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
13820 MORSE ST, CEDAR LAKE, IN 46303-9645
(219) 695-1144
Mailing address
13820 MORSE ST, CEDAR LAKE, IN 46303-9645
(219) 695-1144
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33010576A
IN
Other
Enumeration date
04/05/2022
Last updated
01/31/2024
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