LARISSA JOELLE BLOOM

SACATON, AZ
NPI1568098846
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: AZ  LASAC-15335)
Enumeration Date2020-03-18
Last Update Date2020-03-18
Business Address
LARISSA JOELLE BLOOM LASAC
483 W SEED FARM RD
SACATON, AZ 85147-5000
Phone number: 602-528-1200
Mailing Address
LARISSA JOELLE BLOOM LASAC
PO BOX 36
SACATON, AZ 85147-0001
Phone number:
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