Katherine Blum, MS, MED
Counselor, Professional in Libertyville, IL. Individual provider (NPI-1).
NPI number1679989388
StatusActive
Last updated in NPPESNov 2, 2016
Details
- NPI
- 1679989388
- Entity type
- Individual (NPI-1)
- Name
- Katherine Blum
- Credential
- MS, MED
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 2, 2014
- Last updated
- Nov 2, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 178012403 | IL | Yes |
Practice location
1113 S Milwaukee Ave104
Libertyville, IL 60048-3758
Phone 847-367-5991
Mailing address
1113 S Milwaukee Ave104
Libertyville, IL 60048-3758
Phone 847-367-5991
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