Individual
JERRY BLUME
Active
Individual
JERRY BLUME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
LICSW12647
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
340M8BL
MN BCBS
MN
01
—
6261296
MEDICA UBH
MN
01
—
HP34163
HEALTH PARTNERS
MN
Enumeration date
09/25/2006
Last updated
07/09/2007
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