Individual
MARY KATE BLOOMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
873 HARWICH RD, BREWSTER, MA 02631-5232
(508) 896-9003
Mailing address
157 BLOOMER PATH, BREWSTER, MA 02631-1240
(508) 221-5745
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2542
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2542
DIVISION OF PROFESSIONAL PROFESSIONAL LICENSURE
MA
Enumeration date
07/18/2016
Last updated
07/18/2016
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