Individual
RENAE LUVERL BLOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
3004 W ROSE CREST DR, SIOUX FALLS, SD 57108-1719
(605) 331-4765
Mailing address
3004 W ROSE CREST DR, SIOUX FALLS, SD 57108-1719
(605) 331-4765
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
01084097
SD
Other
Enumeration date
01/21/2008
Last updated
01/21/2008
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