# OUTBLOOM THERAPY SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205653391
- **Authorized official:** DR. ERICKA JOBE PHD, LSCSW, LCSW (CLINICIAN/OWNER)
- **Authorized official phone:** (405) 296-3813

## Contact information

- **Practice address:** 10100 W MAPLE ST STE 102, WICHITA, KS 67209-3148
- **Practice address phone:** (316) 295-3495
- **Mailing address:** 9905 S PENNSYLVANIA AVE STE A, OKLAHOMA CITY, OK 73159-6920
- **Mailing address phone:** (405) 296-3813

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 09/20/2024
- **Last updated:** 09/20/2024