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Individual

MR. JEFFREY IRA BLAU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW LCSW

Contact information

Practice address
475 MORGAN HIGHWAY, CHARLES LUGER BLDG, SCRANTON, PA 18508
(570) 207-7919
(570) 963-1953
Mailing address
217 WEST GROVE STREET, CLARKS SUMMIT, PA 18411

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW014412
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BL603478
FEDERAL BLUE SHIELD
PA
Enumeration date
11/24/2006
Last updated
07/08/2007
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