Organization
BLOOMIVERSE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEGAN COLTONIAK MT-BC (EXECUTIVE DIRECTOR)
(716) 982-5170
Entity
Organization
Contact information
Practice address
7821 ERIE RD, DERBY, NY 14047-9502
(716) 549-0585
Mailing address
73 ROVNER PL, HAMBURG, NY 14075-4205
Taxonomy
Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
—
—
Other
Enumeration date
06/02/2017
Last updated
01/23/2024
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