Jake B Bloom, LPC Valid NPI

Individual provider · Mental Health Counselor · Menomonie, WI

NPI

1730712308

Type

Individual (Type 1)

Primary specialty

Mental Health Counselor (Counselor)

Specialty group

Behavioral Health & Social Service Providers

Taxonomy code

101YM0800X

License number

4058-125 (WI)

Sex

Male

Sole proprietor

No

Enumerated

2020-02-21

Last updated

2020-12-02