DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. SUSAN DOROTHY BLOM, PH.D.

Active Sole Proprietor

DR. SUSAN DOROTHY BLOM, PH.D. is a Psychologist healthcare provider located in MORA, Minnesota. NPI 1700957842 is currently active in the NPPES registry. Verify at CMS.

Psychologist · MORA, MN

Registration Details

NPI Number
1700957842
Provider Type
Individual
Gender
Female
NPI Issued
Nov 12, 2006 (19.720056736307 yrs)
Last Updated
Jul 8, 2007
License
LP1194 (MN)
Sole Proprietor
Yes

Practice Information

Address
905 FOREST AVE E
SUITE 150
MORA, MN, 550511624
Browse MN providers · Browse ZIP 55051
Phone
3206796346
Fax
3206796351
Primary Specialty
Psychologist
103T00000X

Other Psychologist Providers in MORA, MN

Name Credential NPI
MRS. DARCI JEAN WIKELIUS PSY.D., LP 1366970352
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.