ELIJAH BENJAMIN BLASE

MINNEAPOLIS, MN
NPI1750198248
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: MN  33354)
Enumeration Date2024-12-17
Last Update Date2024-12-17
Business Address
ELIJAH BENJAMIN BLASE LICSW
2213 W 54TH ST
MINNEAPOLIS, MN 55419-1515
Phone number: 847-477-9964
Mailing Address
ELIJAH BENJAMIN BLASE LICSW
3640 43RD AVE S
MINNEAPOLIS, MN 55406-2823
Phone number: 847-477-9964