Organization
BLOSSOM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARGARET HERIN MS, RD, LD (DIETIAN)
(901) 288-5875
Entity
Organization
Contact information
Practice address
909 N AVALON ST, MEMPHIS, TN 38107-5008
(901) 288-5875
Mailing address
909 N AVALON ST, MEMPHIS, TN 38107-5008
(901) 288-5875
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
133VN1004X
Pediatric Nutrition Registered Dietitian
—
—
133VN1501X
Sports Dietetics Nutrition Registered Dietitian
—
—
Other
Enumeration date
12/12/2024
Last updated
12/29/2024
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