Provider Demographics
NPI:1366689523
Name:BLOOMFIELD, LINDA MARIE (B C -HIS)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:MARIE
Last Name:BLOOMFIELD
Suffix:
Gender:F
Credentials:B C -HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 LAKEWOOD VILLAGE PL
Mailing Address - Street 2:SUITE D
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-8034
Mailing Address - Country:US
Mailing Address - Phone:501-765-3941
Mailing Address - Fax:
Practice Address - Street 1:2600 LAKEWOOD VILLAGE PL
Practice Address - Street 2:SUITE D
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-8034
Practice Address - Country:US
Practice Address - Phone:501-765-3941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-09
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR601237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist