Individual
GAIL BLOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA OTR CHT
Contact information
Practice address
1101 OHIO DR, STE 105, PLANO, TX 75093
(972) 599-9594
(972) 599-9364
Mailing address
1101 OHIO DR, STE 105, PLANO, TX 75093
(972) 599-9594
(972) 599-9364
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
103249
TX
225XH1200X
Hand Occupational Therapist
103249
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4724960001
PALMETTO GBA DMERC
TX
01
—
8T0248
BLUE CROSS BLUE SHIELD
TX
Enumeration date
04/26/2006
Last updated
10/28/2010
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