| NPI | 1073727541 |
|---|---|
| Former Name | ELIZABETH RENE BLOOM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: MA 1016) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: AR A415) |
| 224Z00000X Occupational Therapy Assistant (Licence: CA 1232) | |
| 224Z00000X Occupational Therapy Assistant (Licence: NH 0213) | |
| 224Z00000X Occupational Therapy Assistant (Licence: FL 07884) | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2007-07-08 |