| Bloom Psychology Services, Llc | |
|
10100 Lantern Rd Ste 125 Fishers IN 46037-7806 | |
| (317) 775-3942 | |
| (317) 775-3942 |
| Full Name | Bloom Psychology Services, Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 10100 Lantern Rd Ste 125, Fishers, Indiana |
| Authorized Official Name and Position | Jennifer Tarbox Boodro (OWNER/PRESIDENT) |
| Authorized Official Contact | 3177712077 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloom Psychology Services, Llc 10100 Lantern Rd Ste 125 Fishers IN 46037-7806 Ph: (317) 775-3942 | Bloom Psychology Services, Llc 10100 Lantern Rd Ste 125 Fishers IN 46037-7806 Ph: (317) 775-3942 |
| NPI Number | 1730425257 |
|---|---|
| Provider Enumeration Date | 01/02/2013 |
| Last Update Date | 04/10/2023 |
| Certification Date | 04/10/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730425257 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 20042417A (Indiana) | Primary |
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