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Organization
BLOSSOM OSTOMY INC
Active
Organization
BLOSSOM OSTOMY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NINA HAYES (FOUNDER)
(617) 224-2698
Entity
Organization
Contact information
Practice address
13488 MAXELLA AVE APT 626, MARINA DEL REY, CA 90292-4304
(617) 224-2698
Mailing address
13488 MAXELLA AVE APT 626, MARINA DEL REY, CA 90292-4304
(617) 224-2698
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
—
NULL
171400000X
Health & Wellness Coach
Primary
—
—
172V00000X
Community Health Worker
—
NULL
172V00000X
Community Health Worker
—
—
174H00000X
Health Educator
—
NULL
174H00000X
Health Educator
—
—
Other
Enumeration date
08/02/2025
Last updated
08/02/2025
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