Individual
REBECCA BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 SPRING HARBOR DR, COLUMBUS, GA 31904-4619
(706) 641-0424
Mailing address
695 DRAPER RD, WILLIAMSTOWN, KY 41097-4867
(513) 515-4428
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972084127
—
OH
Enumeration date
08/26/2018
Last updated
03/30/2022
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