Provider Demographics
NPI:1285992529
Name:BLOODGOOD, JANET HELEN (PHD)
Entity type:Individual
Prefix:DR
First Name:JANET
Middle Name:HELEN
Last Name:BLOODGOOD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 COVENTRY DR
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-1971
Mailing Address - Country:US
Mailing Address - Phone:908-454-4070
Mailing Address - Fax:908-454-4071
Practice Address - Street 1:600 COVENTRY DR
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1971
Practice Address - Country:US
Practice Address - Phone:908-454-4070
Practice Address - Fax:908-454-4071
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-24
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00512900103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical