Dr Stanley Wayne Blom, PHD | |
150 W Angela Blvd, South Bend, IN 46617-1101 | |
(574) 251-1286 | |
(574) 232-5386 |
Full Name | Dr Stanley Wayne Blom |
---|---|
Gender | Male |
Speciality | Psychologist - Clinical |
Location | 150 W Angela Blvd, South Bend, Indiana |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1538119912 | NPI | - | NPPES |
200008720 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | 20040666A (Indiana) | Primary |
Mailing Address | Practice Location Address |
---|---|
Dr Stanley Wayne Blom, PHD 150 W Angela Blvd, South Bend, IN 46617-1101 Ph: (574) 251-1286 | Dr Stanley Wayne Blom, PHD 150 W Angela Blvd, South Bend, IN 46617-1101 Ph: (574) 251-1286 |
Rachel Njuguna, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 403 E Madison St, South Bend, IN 46617 Phone: 574-283-1107 Fax: 574-283-1131 | |
Barbara S Searle, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3603 E Jefferson Blvd, Suiteb, South Bend, IN 46615 Phone: 574-237-1003 Fax: 574-237-1006 | |
Dr. George Gilbert Moss, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 22057 Sandybrook Dr, South Bend, IN 46628 Phone: 574-514-4302 | |
Nicole Gebadlo, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2505 E Jefferson Blvd, South Bend, IN 46615 Phone: 574-289-4831 Fax: 574-234-2075 | |
Lisa Annette Ward, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 737 Beale St, South Bend, IN 46616 Phone: 574-393-6120 | |
Vaughn Thomas Mawhinney, PH.D. Psychologist Medicare: Medicare Enrolled Practice Location: 828 E Colfax Ave, South Bend, IN 46617 Phone: 574-251-1531 Fax: 574-234-5710 | |
Joann Michelle Jackson, PSY.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 403 E Madison St, South Bend, IN 46617 Phone: 574-533-1234 Fax: 574-537-2652 |