Organization
BLOSSOM HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY BETH HOUPT (CREDENTIALING)
(517) 676-9788
Entity
Organization
Contact information
Practice address
2156 GLENCOE HILLS DR APT 12, ANN ARBOR, MI 48108
(734) 347-1690
Mailing address
PO BOX 10, MASON, MI 48854-0010
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801065043
MI
Other
Enumeration date
04/11/2018
Last updated
07/05/2018
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