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1538119912
STANLEY WAYNE BLOM
SOUTH BEND, IN
NPI
1538119912
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Other Name
STAN BLOM, PH.D., INC
Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: IN 20040666A)
Enumeration Date
2006-05-10
Last Update Date
2019-08-12
Business Address
Dr. STANLEY WAYNE BLOM Ph.D.
150 W ANGELA BLVD
SOUTH BEND, IN 46617-1101
Phone number: 574-251-1286
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Mailing Address
Dr. STANLEY WAYNE BLOM Ph.D.
150 W ANGELA BLVD
SOUTH BEND, IN 46617-1101
Phone number: 574-251-1286
Copy
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