STANLEY WAYNE BLOM

SOUTH BEND, IN
NPI1538119912
Other NameSTAN BLOM, PH.D., INC
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy103TC0700X Psychologist, Clinical
(Licence: IN  20040666A)
Enumeration Date2006-05-10
Last Update Date2019-08-12
Business Address
Dr. STANLEY WAYNE BLOM Ph.D.
150 W ANGELA BLVD
SOUTH BEND, IN 46617-1101
Phone number: 574-251-1286
Mailing 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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