Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X |
| NPI # | 1073824991 |
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| LBN Legal business name | BLOOM COUNSELING, PC | ||||
| Authorized official | MATTHEW BLOOM - (CHIEF EXECUTIVE OFFICER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 06/25/2010 | ||||
| Last updated | 06/29/2010 - About 16 years ago | ||||
| Identifiers |
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