Individual
JENNIFER BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 BRADLEY PARK LN APT 134, CUMMING, GA 30040-3049
(561) 252-7815
Mailing address
100 BRADLEY PARK LN APT 134, CUMMING, GA 30040-3049
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC011388
GA
101YM0800X
Mental Health Counselor
MH16633
FL
Other
Enumeration date
02/03/2017
Last updated
07/09/2020
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