Individual
RAY M ROSENBLOOM
Active
Individual
RAY M ROSENBLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
33167
TX
103TC0700X
Clinical Psychologist
6301002325
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11287287
CAQH
—
01
—
620F34837
BLUE CROSS BLUE SHIELD MI
MI
Enumeration date
12/01/2006
Last updated
08/04/2019
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