| Doctor Name: | MR. JOHN JOSEPH BLUM |
| NPI Number: | 1114074887 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC, LCADC |
| License Number: | 37PC00038600 |
| Business Practice Address: | 74 E 2nd St 2nd Floor Moorestown, NJ - 080573318 |
| Business Phone Number: | 8563042469 |
| Business Fax Number: | 8566081809 |
| Mailing Address: | Po Box 823, MOORESTOWN |
| State: | NJ |
| Postal Code: | 080570823 |
| Phone Number: | 8563042469 |
| Fax Number: | 8566081809 |
| NPI Enumeration Date: | 01/04/2007 |
| NPI Last Update Date: | 09/04/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 37PC00038600 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |