Individual
AMANDA R BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
305 LOCUST AVE, OAKDALE, NY 11769-1652
(631) 218-5951
Mailing address
131 LONGFELLOW AVE, NORTH BABYLON, NY 11703-4706
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
009897-1
NY
Other
Enumeration date
04/01/2019
Last updated
04/01/2019
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