Individual
GREGORY P BLUME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
444 N WESTHILL BLVD, APPLETON, WI 54914-5715
(920) 750-7036
Mailing address
444 N WESTHILL BLVD, APPLETON, WI 54914-5715
(920) 750-7036
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3305-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39203900
—
WI
Enumeration date
03/03/2008
Last updated
02/27/2013
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