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Organization
DOUGLASS R. BLOOMFIELD, PH.D., P.C.
Active
Organization
DOUGLASS R. BLOOMFIELD, PH.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLASS R BLOOMFIELD PH.D. (CLINICAL PSYCHOLOGIST)
(804) 264-0966
Entity
Organization
Contact information
Practice address
5821 STAPLES MILL RD, RICHMOND, VA 23228-5427
(804) 264-0966
(804) 264-1029
Mailing address
5821 STAPLES MILL RD, RICHMOND, VA 23228-5427
(804) 264-0966
(804) 264-1029
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
0810000979
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007758715
—
VA
Enumeration date
02/03/2012
Last updated
02/03/2012
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