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1225604499
NATHAN ALLEN BLASA
JERSEYVILLE, IL
NPI
1225604499
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IL 149023186)
Enumeration Date
2021-05-28
Last Update Date
2021-05-28
Business Address
NATHAN ALLEN BLASA LCSW
1006 IL-16
JERSEYVILLE, IL 62052
Phone number: 618-310-3270
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Mailing Address
NATHAN ALLEN BLASA LCSW
20921 S CREEK RD
GRAFTON, IL 62037-2037
Phone number: 618-978-8453
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