Individual
JERRY LYNN BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.S., CADC
Contact information
Practice address
724 N 3RD ST, BURLINGTON, IA 52601-5001
(319) 752-4000
(319) 752-6933
Mailing address
724 N 3RD ST, BURLINGTON, IA 52601-5001
(319) 752-4000
(319) 752-6933
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
05002
IA
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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