Organization
GWEN S. BLOOM LCSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWEN SUSAN BLOOM LCSW (OWNER)
(732) 501-5917
Entity
Organization
Contact information
Practice address
3322 ROUTE 22, SUITE 428, BRANCHBURG, NJ 08876-3476
(732) 501-5917
Mailing address
21 KINGSWOOD RD, BRANCHBURG, NJ 08876-7428
(732) 501-5917
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05137300
NJ
Other
Enumeration date
04/11/2017
Last updated
03/02/2018
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