Individual
LYNETTE CAREEN BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC I
Contact information
Practice address
1011 COMMERCIAL ST NE STE 110, SALEM, OR 97301-1036
(503) 983-9900
(503) 983-9899
Mailing address
1332 HAWK DR, CENTRAL POINT, OR 97502-3567
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15-06-02
OR
Other
Enumeration date
07/09/2010
Last updated
04/02/2024
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