Barbara Blom | |
477 S Main St Plymouth MI 48170-1708 | |
(734) 646-6031 | |
(734) 975-2909 |
Full Name | Barbara Blom |
---|---|
Speciality | Social Worker |
Location | 477 S Main St, Plymouth, Michigan |
Authorized Official Name and Position | Barbara A. Blom (MENTAL HEALTH PROFESSIONAL) |
Authorized Official Contact | 7346466031 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Barbara Blom 413 Courtland Road Ypsilanti MI 48197-1829 Ph: (734) 646-6031 | Barbara Blom 477 S Main St Plymouth MI 48170-1708 Ph: (734) 646-6031 |
NPI Number | 1316377781 |
---|---|
Provider Enumeration Date | 11/20/2013 |
Last Update Date | 06/03/2015 |
Medicare PECOS PAC ID | 9739493180 |
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Medicare Enrollment ID | O20150730010737 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316377781 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 6801058302 (Michigan) | Primary |
Provider Name | Barbara A Blom |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1033428115 PECOS PAC ID: 0840469508 Enrollment ID: I20110815000184 |
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