Individual
DR. ALLAN JEROME BLAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
1101 BRISTOL RD, MOUNTAINSIDE, NJ 07092-2311
(908) 543-0220
Mailing address
1451 ORCHARD RD, MOUNTAINSIDE, NJ 07092-1710
(908) 531-1340
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
107977
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107911
COMMONWEALTH OF MASSACHUSETTS DIVISION OF PROFESSIONAL LICENSURE
MA
Enumeration date
07/31/2018
Last updated
07/31/2018
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