Bloom, Audrey

Bloom, Audrey is an sole proprietor health care provider with primary practice located at 10475 Medlock Bridge Rd Building 300, Suite 315, Duluth GA 30097-2002. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Bloom, Audrey can be contacted via phone (678) 935-9567.

Contact Information

Primary practice address
10475 Medlock Bridge Rd Building 300, Suite 315 Duluth GA 30097-2002
Phone: (678) 935-9567
Fax: (678) 935-9568
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PSY001866 Georgia

Profile Details

NPI number 1922187376
LBN Legal business name Bloom, Audrey
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 6th, 2006
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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