Individual
MS. LIZA REBECCA BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
878 SAINT JOHNS PL APT 1, BROOKLYN, NY 11216-4306
(310) 339-3250
Mailing address
878 SAINT JOHNS PL APT 1, BROOKLYN, NY 11216-4306
(310) 339-3250
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
107033
NY
Other
Enumeration date
08/07/2019
Last updated
08/07/2019
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