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Individual

MS. LAURA BLOOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
7350 HERITAGE VILLAGE PLZ, SUITE 201, GAINESVILLE, VA 20155-3084
(571) 248-0626
(866) 817-3052
Mailing address
7350 HERITAGE VILLAGE PLZ, SUITE 201, GAINESVILLE, VA 20155-3084
(571) 248-0626
(866) 817-3052

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904005151
VA

Other

Enumeration date
03/05/2010
Last updated
03/05/2010
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