Individual
ROBERT BLOOM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
5384 POPLAR AVE, SUITE 313, MEMPHIS, TN 38119-3609
(901) 521-9671
Mailing address
PO BOX 579, OLIVE BRANCH, MS 38654-0579
(662) 895-1707
(662) 893-0388
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
04-4P
AR
103TC0700X
Clinical Psychologist
Primary
P0376
TN
Other
Enumeration date
11/15/2005
Last updated
07/08/2007
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