Doctor Name: | MRS. RUTH ALICE GOLDBLOOM |
NPI Number: | 1093714255 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCPC, LPC, NCC |
License Number: | PC000849 |
Business Practice Address: | 12590 National Pike Suite 2 Grantsville, MD - 215363310 |
Business Phone Number: | 3018953388 |
Business Fax Number: | 3018953399 |
Mailing Address: | 12590 National Pike, P. O. Box 268 GRANTSVILLE |
State: | MD |
Postal Code: | 215363310 |
Phone Number: | 3018953388 |
Fax Number: | 3018953399 |
NPI Enumeration Date: | 07/19/2005 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | PC000849 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |