Organization
BLOOM PSYCHOLOGY SP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRETCHEN HAIST (PRACTICE MANAGER)
(317) 775-3942
Entity
Organization
Contact information
Practice address
10100 LANTERN RD STE 125, FISHERS, IN 46037-7806
(317) 775-3942
(317) 775-3942
Mailing address
10100 LANTERN RD STE 125, FISHERS, IN 46037-7806
(317) 775-3942
(317) 775-3942
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
03/13/2024
Last updated
03/13/2024
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