Individual
DR. MARLENE R. BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
10909 MEMORIAL HWY, TAMPA, FL 33615-2511
(813) 864-1404
Mailing address
10909 MEMORIAL HWY, TAMPA, FL 33615-2511
(813) 864-1404
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY6043
FL
Other
Enumeration date
02/06/2007
Last updated
07/08/2007
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