# THE BLOOM WELLNESS AND THERAPY CENTER

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

## Provider details

- **NPI number:** 1841882610
- **Authorized official:** EDMONIA SIANNEH DOE LPC (FOUNDER)
- **Authorized official phone:** (404) 388-0119

## Contact information

- **Practice address:** 3343 PEACHTREE RD NE STE 145-1685, ATLANTA, GA 30326-1085
- **Practice address phone:** (470) 222-3671
- **Mailing address:** 3343 PEACHTREE RD NE STE 145-1685, ATLANTA, GA 30326-1085
- **Mailing address phone:** (470) 222-3671

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/03/2021
- **Last updated:** 07/03/2023