Individual
KATIE MAE TWILA BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLMHP
Contact information
Practice address
2100 FLETCHER AVE STE 103, LINCOLN, NE 68521-5862
(402) 604-1063
Mailing address
2100 FLETCHER AVE STE 103, LINCOLN, NE 68521-5862
(402) 604-1063
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
13450
NE
Other
Enumeration date
07/31/2023
Last updated
07/31/2023
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