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Individual

MISS DENISE MARIE BLOOM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A. CCC-SLP

Contact information

Practice address
5225 OLD ORCHARD RD, SKOKIE, IL 60077-4405
(847) 663-1020
Mailing address
5225 OLD ORCHARD ROAD, SUITE 18, SKOKIE, IL 60077-1027
(847) 663-1020

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146006969
IL

Other

Enumeration date
09/14/2010
Last updated
09/14/2010
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