Individual
MS. KENDRA SUNDIN BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Contact information
Practice address
1229 W. WASHINGTON ST. SUITE 5, MARQUETTE, MI 49855-0000
(906) 273-1121
(906) 225-6706
Mailing address
1229 W. WASHINGTON ST. SUITE 5, MARQUETTE, MI 49855-0000
(906) 273-1121
(906) 225-6706
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
20258150925
MI
106E00000X
Assistant Behavior Analyst
20045130244
MI
Other
Enumeration date
07/14/2020
Last updated
12/15/2020
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