person
Dr. Staci Bloom, PHD
Student in an Organized Health Care Education/Training Program in Dallas, Texas
NPI 1306179460

Staci Bloom is a Student in an Organized Health Care Education/Training Program based in Dallas, TX. Staci Bloom practices in Dallas, TX and has the professional credentials of PHD. The NPI Number for Staci Bloom is 1306179460 and holds a License No. (Texas).

The current practice location address for Staci Bloom is 7777 Forest Ln, Dallas, TX and can be reached out via phone at 972-566-8466.

Location: 7777 Forest Ln, Dallas, TX, 75230-2505
person
Provider Profile Details
NPI Number
1306179460
Provider Name
Staci Bloom
Credential
PHD
Provider Entity Type
Individual
Gender
Female
Address
7777 Forest Ln, Dallas, TX, 75230-2505
Phone Number
972-566-8466
Fax Number
Provider Enumeration Date
09/08/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
38529 01 NATIONAL CERTIFICATION FOR SCHOOL PSYCHOLOGISTS
institution
Provider Business Practice Location Address Details
Address
7777 Forest Ln
City
State
Zip
75230-2505
Phone Number
972-566-8466
Fax Number
person
Provider Business Mailing Address Details
Address
7777 Forest Ln
City
State
Zip
75230-2505
Phone Number
972-566-8466
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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