| NPI | 1386123651 |
|---|---|
| Former Name | CORINNE ELICIA BLOOM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: AL 2025-058) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 106E00000X Assistant Behavior Analyst | |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2025-05-30 |