Doctor Name: | DIANE GWEN BLOOR |
NPI Number: | 1225059744 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APSW |
License Number: | 240-121 |
Business Practice Address: | 6040 W Lisbon Ave Milwaukee, WI - 532102116 |
Business Phone Number: | 4148719111 |
Business Fax Number: | 4148719121 |
Mailing Address: | 6040 W Lisbon Ave, MILWAUKEE |
State: | WI |
Postal Code: | 532102116 |
Phone Number: | 4148719111 |
Fax Number: | 4148719121 |
NPI Enumeration Date: | 07/21/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 240-121 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |