DR. Stanley Wayne Blom, PH.D.
NPI #1538119912 in South Bend, Indiana
Provider Information
- NPI Number
- 1538119912
- Entity Type
- Individual
- Name
- DR. Stanley Wayne Blom, PH.D.
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Psychologist - Clinical
- Credential
- PH.D.
- Enumeration Date
- May 10, 2006
- Last Updated
- Aug 12, 2019
Practice Location
- Address
- 150 W ANGELA BLVD
- City
- South Bend
- State
- Indiana
- ZIP Code
- 46617-1101
- Phone
- (574) 251-1286
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist - Clinical — Clinical |
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