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General NPI Number Information
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NPI Number | 1396655809
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Entity Type | Individual
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Provider Name | EMILY GRACE BLOUGH LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/08/2026
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Last Update Date | 09/08/2026
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Provider Practice Location Address
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Address Line | 235 PENN ST
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City | WESTFIELD
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State | IN
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Zip | 46074-9460
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Country | US
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Telephone | 317-643-1545
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Fax |
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Provider Business Mailing Address
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Address Line | 205 CRANSTON AVE
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City | CARMEL
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State | IN
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Zip | 46032-4543
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34013156A
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License Number State | IN
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