Theresa Rose Bloss

NPI #1003357088 in Traverse City, Michigan

Provider Information

NPI Number: 1003357088
Entity Type: Individual
Name: Theresa Rose Bloss
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Mar 10, 2017
Last Updated: Mar 10, 2017

Practice Location

Address: 1363 DOUGLAS DR
Address 2: SUITE 104
City: Traverse City
State: Michigan
ZIP Code: 49696-8980
Phone: (231) 668-4909

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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