| NPI | 1831759877 |
|---|---|
| Former Name | BREAUNNAH ELAINE BLOOMER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: LA 325879) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA 313326) |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2025-09-10 |