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Organization

BLOSSOM ON PURPOSE THERAPY & CONSULTING, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VICKY BAKER LCSW (OWNER/THERAPIST)
(501) 243-8977
Entity
Organization

Contact information

Practice address
140 MUNICIPAL DRIVE, JACKSONVILLE, AR 72076-4274
(501) 243-8977
Mailing address
140 MUNICIPAL DR, JACKSONVILLE, AR 72076-4274

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Enumeration date
04/23/2025
Last updated
04/23/2025
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