Individual
KATIE M BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-PIP
Contact information
Practice address
1710 W 18TH ST, SIOUX FALLS, SD 57104-4527
(605) 338-3639
Mailing address
1710 W 18TH ST, SIOUX FALLS, SD 57104-4527
(605) 338-3639
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3131
SD
Other
Enumeration date
11/16/2014
Last updated
11/16/2014
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