| Doctor Name: | MS. VIRGINIA ADAMS BLOOM |
| NPI Number: | 1003093584 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MED, LPC |
| License Number: | 10301 |
| Business Practice Address: | 1310 S 1st St Ste 200 Austin, TX - 787043061 |
| Business Phone Number: | 5126270390 |
| Business Fax Number: | 5122881909 |
| Mailing Address: | 1310 S 1st St Ste 200, AUSTIN |
| State: | TX |
| Postal Code: | 787043061 |
| Phone Number: | 5126270390 |
| Fax Number: | 5122881909 |
| NPI Enumeration Date: | 01/27/2008 |
| NPI Last Update Date: | 01/27/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 10301 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |