NPI | 1144477480 |
---|---|
Former Name | WENDY ELLEN BLOOM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW11682) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC04931900) |
Enumeration Date | 2008-08-19 |
Last Update Date | 2019-09-04 |