Individual
CARLY SUZANNE BLOOMFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1704 OLIVE ST, CONCORDIA, KS 66901-4934
(785) 243-4236
(785) 243-6119
Mailing address
4505 E 47TH ST S, WICHITA, KS 67210-1651
(316) 529-9100
(316) 529-9351
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
7779
KS
Other
Enumeration date
06/24/2010
Last updated
06/24/2010
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