Individual
JENNIFER HANSON BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
1505 ORCHID AVE, WINTER PARK, FL 32789-5649
(407) 644-4692
Mailing address
1505 ORCHID AVE, WINTER PARK, FL 32789-5649
(407) 644-4692
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MT3690
FL
Other
Enumeration date
08/28/2019
Last updated
08/28/2019
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