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Kathleen Bloom
Professional Counselor in Grand Rapids, Michigan
NPI 1952794950

Kathleen Bloom is a Professional Counselor based in Grand Rapids, MI and is specialized in Professional. Kathleen Bloom practices in Grand Rapids, MI. The NPI Number for Kathleen Bloom is 1952794950 and holds a License No. 6401001493 (Michigan).

The current practice location address for Kathleen Bloom is 1558 Pine Ave Nw, Grand Rapids, MI and can be reached out via phone at 616-901-2777 and via fax at 616-336-4333.

Location: 1558 Pine Ave Nw, Grand Rapids, MI, 49504-3029
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Provider Profile Details
NPI Number
1952794950
Provider Name
Kathleen Bloom
Credential
Provider Entity Type
Individual
Gender
Female
Address
1558 Pine Ave Nw, Grand Rapids, MI, 49504-3029
Phone Number
616-901-2777
Fax Number
616-336-4333
Provider Enumeration Date
03/15/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
101YO2500X 05 MI
institution
Provider Business Practice Location Address Details
Address
1558 Pine Ave Nw
City
State
Zip
49504-3029
Phone Number
616-901-2777
Fax Number
616-336-4333
person
Provider Business Mailing Address Details
Address
1558 Pine Ave Nw
City
State
Zip
49504-3029
Phone Number
616-901-2777
Fax Number
616-336-4333
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
6401001493 (Michigan)
Definition
Definition to come...
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