# WALLFLOWERS BLOOM FAMILY THERAPY INC

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

## Provider details

- **NPI number:** 1588260319
- **Authorized official:** NICOLE SEGROVES (PRACTICE MANAGER)
- **Authorized official phone:** (661) 874-7851

## Contact information

- **Practice address:** 25000 AVENUE STANFORD STE 240, VALENCIA, CA 91355-4598
- **Practice address phone:** (818) 414-8507
- **Mailing address:** 13883 GARBER ST, ARLETA, CA 91331-5431
- **Mailing address phone:** (818) 414-8507

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 12/08/2020
- **Last updated:** 04/23/2021