Individual
JACQUELINE BLUEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCC, LADC
Contact information
Practice address
7580 160TH STREET WEST, LAKEVILLE, MN 55044
(612) 871-0118
(612) 870-2403
Mailing address
7580 160TH STREET WEST, LAKEVILLE, MN 55044
(651) 356-2938
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
302710
MN
Other
Enumeration date
11/04/2009
Last updated
01/29/2018
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