Individual
JENNIFER BLOSSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
6 E CHESTNUT ST, AUGUSTA, ME 04330-5758
(207) 623-2977
(207) 623-9374
Mailing address
6 E CHESTNUT ST, AUGUSTA, ME 04330-5758
(207) 623-2977
(207) 623-9374
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PS2514
ME
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/25/2017
Last updated
10/28/2025
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