Individual
MS. AUDREY BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2000 S DIXIE HWY, SUITE 104, COCONUT GROVE CENTER, MIAMI, FL 33133-2456
(305) 301-8251
Mailing address
17142 SW 112TH CT, MIAMI, FL 33157-3907
(305) 301-8251
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10388
FL
Other
Enumeration date
06/02/2011
Last updated
06/02/2011
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