| Bloom Therapy Llc | |
|
1616 E 19th St Ste 3 Cheyenne WY 82001-4946 | |
| (307) 214-0229 | |
| Not Available |
| Full Name | Bloom Therapy Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1616 E 19th St Ste 3, Cheyenne, Wyoming |
| Authorized Official Name and Position | Abigail Lane (THERAPIST/OWNER) |
| Authorized Official Contact | 3072140229 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloom Therapy Llc 1616 E 19th St Ste 3 Cheyenne WY 82001-4946 Ph: (307) 214-0229 | Bloom Therapy Llc 1616 E 19th St Ste 3 Cheyenne WY 82001-4946 Ph: (307) 214-0229 |
| NPI Number | 1871355529 |
|---|---|
| Provider Enumeration Date | 01/29/2024 |
| Last Update Date | 02/15/2024 |
| Certification Date | 02/15/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871355529 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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