Individual
DR. CAROL SUE BLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
6610 VISTA DEL REINO, LAS CRUCES, NM 88007-8920
(575) 556-9493
Mailing address
6610 VISTA DEL REINO, LAS CRUCES, NM 88007-8920
(406) 381-0645
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
1476
NM
103TC0700X
Clinical Psychologist
1486
HI
103TC0700X
Clinical Psychologist
Primary
257
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490165
—
MT
05
—
492921
—
MT
01
—
50771
BCBS
MT
Enumeration date
12/28/2006
Last updated
01/10/2025
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