Individual
BETTY J BLOME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW/LCSW
Contact information
Practice address
1510 WHITEHALL RD APT A, ROLLA, MO 65401-3776
(573) 465-1040
Mailing address
1510 WHITEHALL RD APT A, ROLLA, MO 65401-3776
(573) 465-1040
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
004643
MO
Other
Enumeration date
04/19/2022
Last updated
04/19/2022
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