Bloom Therapy LLC
Counselor in Twin Falls, ID. Organization (NPI-2).
NPI number1720794852
StatusActive
Last updated in NPPESFeb 3, 2023
Details
- NPI
- 1720794852
- Entity type
- Organization (NPI-2)
- Legal business name
- Bloom Therapy LLC
- Organization subpart
- No
- Enumeration date
- Jan 23, 2023
- Certification date
- Feb 3, 2023
- Last updated
- Feb 3, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | – | – | Yes |
Practice location
112 Shoshone St. E.Suite 210Twin Falls, ID 83301-8330
Phone 208-420-5336
Mailing address
847 Sun Peak WayTwin Falls, ID 83301-8977
Phone 208-420-5336
Authorized official
Irma Pavlovic
Owner
2084205336
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