Provider Demographics
NPI:1558113969
Name:ABLOOM PSYCHOLOGICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:ABLOOM PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:VIOLA
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:724-882-2339
Mailing Address - Street 1:4520 OLD WILLIAM PENN HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:MURRYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15668-1907
Mailing Address - Country:US
Mailing Address - Phone:724-882-2339
Mailing Address - Fax:
Practice Address - Street 1:4520 OLD WILLIAM PENN HWY STE 200
Practice Address - Street 2:
Practice Address - City:MURRYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15668-1907
Practice Address - Country:US
Practice Address - Phone:724-882-2339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health