Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. STANLEY WAYNE BLOM, PH.D.
Active Sole ProprietorDR. STANLEY WAYNE BLOM, PH.D. is a Clinical Psychologist healthcare provider located in SOUTH BEND, Indiana. NPI 1538119912 is currently active in the NPPES registry. Verify at CMS.
Clinical Psychologist · SOUTH BEND, IN
Registration Details
- NPI Number
- 1538119912
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 10, 2006 (20.236414608559 yrs)
- Last Updated
- Aug 12, 2019
- License
-
20040666A (IN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
150 W ANGELA BLVDSOUTH BEND, IN, 466171101Browse IN providers · Browse ZIP 46617
- Phone
- 5742511286
- Fax
- 5742325386
- Primary Specialty
-
Clinical Psychologist
103TC0700X
Other Clinical Psychologist Providers in SOUTH BEND, IN
| Name | Credential | NPI |
|---|---|---|
| DR. JOSEPH RICHARD VENEMA | PH.D. | 1407857592 |
| DR. CATHERINE MAXWELL | PH.D. | 1578553798 |
| LOREN J BURTON | PHD HSPP | 1851367361 |
| BRADLEY S MAZICK | PHD,HSPP | 1518933779 |
| MARIA L BECKER | HSPP | 1497721542 |
| VICTOR T TAN | PSY.D HSPP | 1689641243 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.