| 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 |