Individual
CARRIE BERNICE BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2101 COURAGE DR, FAIRFIELD, CA 94533-6717
(707) 784-2140
Mailing address
142 DEL LOMA CT, VACAVILLE, CA 95687-9478
(707) 447-5238
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/08/2006
Last updated
07/08/2007
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