# BLOSSOMPATH LLC

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

## Provider details

- **NPI number:** 1902795743
- **Authorized official:** NASTAHO M ALI (OWNER)
- **Authorized official phone:** (507) 530-7077

## Contact information

- **Practice address:** 7630 145TH ST W STE 302, SAINT PAUL, MN 55124-7553
- **Practice address phone:** (507) 530-7077
- **Mailing address:** 7630 145TH ST W STE 302, SAINT PAUL, MN 55124-7553

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103K00000X | Behavior Analyst | — | NULL | — |
| 103K00000X | Behavior Analyst | — | — | — |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | Yes |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 06/27/2025
- **Last updated:** 06/27/2025