Individual
KATHERINE BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
250 W 99TH ST APT 2D, NEW YORK, NY 10025-5442
(917) 273-0532
Mailing address
928 AMSTERDAM AVE APT 2, NEW YORK, NY 10025-3604
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/28/2019
Last updated
04/28/2019
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