Individual
BRIANNA ELAINA BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
405 E EXCELSIOR AVE, VINITA, OK 74301-4226
(918) 256-6476
(918) 256-3628
Mailing address
405 E EXCELSIOR AVE, VINITA, OK 74301-4226
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/14/2021
Last updated
09/14/2021
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