Individual
LINDA BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
330 S WHITNEY WAY, SUITE 304, MADISON, WI 53705-4638
(608) 231-3191
(608) 231-3108
Mailing address
330 S WHITNEY WAY, SUITE 304, MADISON, WI 53705-4638
(608) 231-3191
(608) 231-3108
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
990-057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38047900
—
WI
Enumeration date
08/01/2006
Last updated
05/29/2012
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