Most Relevant Information
Provider Data
| NPI Number: | 1003347626 |
| Provider Name: | MARY BLOMGREN CASAC. LMHC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | 27882 |
Most Important Dates
| Enumeration Date: | 03/24/2017 |
| Last Updated: | 01/25/2023 |
Provider Practice Location
79 N CLINTON AVE
ROCHESTER
NY
146041407
Practice Location Phone/Fax
| Phone: | 3153312300 |
| Fax: |
Provider Mailing Location
79 N CLINTON AVE
ROCHESTER
NY
146041407
Provider Mailing Phone/Fax
| Phone: | 5853974648 |
| Fax: |