Individual
MRS. BOBBYJO BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, IBCLC, CCE
Contact information
Practice address
209 RANGE RD, WILTON, CT 06897-3923
(301) 807-3508
Mailing address
209 RANGE RD, WILTON, CT 06897-3923
(203) 210-5246
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
087534
CT
163WL0100X
Lactation Consultant (Registered Nurse)
101-17052
MD
163WL0100X
Lactation Consultant (Registered Nurse)
R143852
MD
Other
Enumeration date
05/14/2007
Last updated
01/14/2009
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