Blons, Charles Roderick

Blons, Charles Roderick is an sole proprietor health care provider with primary practice located at 9001 E Bloomington Fwy Suite 139, Bloomington MN 55420-3435. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Blons, Charles Roderick can be contacted via phone (952) 881-6797.

Contact Information

Primary practice address
9001 E Bloomington Fwy Suite 139 Bloomington MN 55420-3435
Phone: (952) 881-6797
Fax: (952) 881-2028
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X LP4351 Minnesota

Profile Details

NPI number 1578527628
LBN Legal business name Blons, Charles Roderick
Credentials PH.D., L.P.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 14th, 2006
Last updated Jul 2nd, 2010 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578527628 NPPES
Minnesota Other 295L6BL BLUE CROSS BLUE SHIELD
Minnesota Other 30247-02 BLUE CROSS BLUE SHIELD
Minnesota MEDICAID 430048300 BLUE CROSS BLUE SHIELD

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