NPI | 1902318066 |
---|---|
Former Name | ALLISON BETH BLOOM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 222Q00000X Developmental Therapist |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9110749) |
363AM0700X Physician Assistant, Medical | |
106S00000X Behavior Technician | |
Enumeration Date | 2017-10-30 |
Last Update Date | 2025-07-28 |