Individual
JULIET BEVAN BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LGSW
Contact information
Practice address
1 KENTON DR STE 200, CHARLESTON, WV 25311-1256
(304) 460-5123
Mailing address
1 KENTON DR STE 200, CHARLESTON, WV 25311-1256
(304) 460-5123
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
BP00946456
WV
Other
Enumeration date
05/05/2023
Last updated
05/05/2023
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