Individual
BARBARA BLOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, CAC
Contact information
Practice address
477 S MAIN ST, PLYMOUTH, MI 48170-1708
(734) 416-3341
Mailing address
477 S MAIN ST, PLYMOUTH, MI 48170-1708
(734) 416-3341
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
680101058302
MI
Other
Enumeration date
10/06/2010
Last updated
05/26/2015
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