Organization
BLOOM BETWEEN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAYLYNNE KOCH PHD, LPC, RPT-S (OWNER & PLAY THERAPIST)
(719) 357-8086
Entity
Organization
Contact information
Practice address
4390 N ACADEMY BLVD STE 201, COLORADO SPRINGS, CO 80918-6657
(719) 357-8086
Mailing address
4390 N ACADEMY BLVD STE 201, COLORADO SPRINGS, CO 80918-6657
(719) 357-8086
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
01/17/2023
Last updated
04/03/2024
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