AUDREY BLOOM

DULUTH, GA
NPI1922187376
Entity TypeIndividual
GenderN/A
Sole Proprietor ?Yes
Primary Taxonomy103T00000X Psychologist
(Licence: GA  PSY001866)
Enumeration Date2006-11-06
Last Update Date2007-07-09
Business Address
Dr. AUDREY BLOOM Ph.D.
10475 MEDLOCK BRIDGE RD BUILDING 300, SUITE 315
DULUTH, GA 30097-2002
Phone number: 678-935-9567
Mailing Address
Dr. AUDREY BLOOM Ph.D.
9555 FENBROOK CT
ALPHARETTA, GA 30022-5106
Phone number: