Individual
MRS. VANESSA MAY BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
805 W MAUMEE ST, ADRIAN, MI 49221-1901
(517) 266-8880
(517) 266-8881
Mailing address
805 W MAUMEE ST, ADRIAN, MI 49221-1901
(517) 266-8880
(517) 266-8881
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401013911
MI
Other
Enumeration date
10/30/2013
Last updated
10/30/2013
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