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Organization
INNERBLOOM THERAPY PRACTICE PC
Active
Organization
INNERBLOOM THERAPY PRACTICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DENISE LYNN GULOTTA LCSW (PRESIDENT)
(773) 969-6030
Entity
Organization
Contact information
Practice address
2656 W MONTROSE AVENUE, SUITE 104, CHICAGO, IL 60618
(773) 969-6030
Mailing address
1235 N CLYBOURN AVE, SUITE A BOX 222, CHICAGO, IL 60610
(773) 969-6030
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/07/2022
Last updated
08/08/2023
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