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Individual

HALLIE BLOOM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5118 CHARLOTTE CIR N, MEMPHIS, TN 38117-2831
(901) 283-4601
Mailing address
5118 CHARLOTTE CIR N, MEMPHIS, TN 38117-2831
(190) 128-3460

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0000002574
TN
101YP2500X
Professional Counselor
Primary
0000002574
TN

Other

Enumeration date
03/13/2023
Last updated
03/13/2023
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