Individual
GAIL BLOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA OTR CHT
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
Update your record
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