Individual
ELISSA KATHERINE BLOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
333 TURNPIKE RD STE 101, SOUTHBOROUGH, MA 01772-1755
(508) 970-6377
Mailing address
71 ORCHARD HILL DR, OXFORD, MA 01540-1822
(774) 275-8919
(774) 275-8919
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/07/2025
Last updated
05/07/2025
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