DR. Susan Dorothy Blom, PH.D.

NPI #1700957842 in Mora, Minnesota

Provider Information

NPI Number: 1700957842
Entity Type: Individual
Name: DR. Susan Dorothy Blom, PH.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Psychologist
Credential: PH.D.
Enumeration Date: Nov 12, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 905 FOREST AVE E
Address 2: SUITE 150
City: Mora
State: Minnesota
ZIP Code: 55051-1624
Phone: (320) 679-6346

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist	103T00000X	Primary

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