Blomquist, Brenna Rae
Blomquist, Brenna Rae is an individual health care provider with primary practice located at 3136 Craig Rd , Eau Claire WI 54701-6109. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Blomquist, Brenna Rae can be contacted via phone (715) 835-9110.Contact Information
Primary practice address
3136 Craig Rd
Eau Claire WI 54701-6109
Phone: (715) 835-9110
Fax: (715) 830-4098
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 13480 | Wisconsin |
Profile Details
| NPI number | 1477614469 |
|---|---|
| LBN Legal business name | Blomquist, Brenna Rae |
| Credentials | CADC III |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 13th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477614469 | NPPES |
| Wisconsin | Other | 13480 | CADC III |
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