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Organization
BLOSSOM FORTH FAMILY COUNSELING INC
Active
Organization
BLOSSOM FORTH FAMILY COUNSELING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERENICE DURAN-GOMEZ M.A., LMFT 129876 (LMFT, CLINICAL DIRECTOR)
(626) 622-5262
Entity
Organization
Contact information
Practice address
710 S MYRTLE AVE # 661, MONROVIA, CA 91016-3423
(626) 622-5262
Mailing address
710 S MYRTLE AVE # 661, MONROVIA, CA 91016-3423
(626) 622-5262
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
11/14/2024
Last updated
11/14/2024
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