| Bloom Counseling Center, Pllc | |
|
2408 Pawnee Ave Altus OK 73521-1520 | |
| (580) 301-4709 | |
| Not Available |
| Full Name | Bloom Counseling Center, Pllc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2408 Pawnee Ave, Altus, Oklahoma |
| Authorized Official Name and Position | Maurisa Mahan (COUNSELOR) |
| Authorized Official Contact | 5803014709 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloom Counseling Center, Pllc Po Box 149 Altus OK 73522-0149 Ph: (580) 301-4709 | Bloom Counseling Center, Pllc 2408 Pawnee Ave Altus OK 73521-1520 Ph: (580) 301-4709 |
| NPI Number | 1609556125 |
|---|---|
| Provider Enumeration Date | 07/19/2023 |
| Last Update Date | 07/19/2023 |
| Certification Date | 07/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609556125 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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