| NPI | 1326052150 |
|---|---|
| Former Name | JOANNE MARIE BLOOM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 5116) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL mh21744) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2025-10-21 |