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Organization

BLOOMING CLEMATIS THERAPY & CONSULTING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VICKI DAVIS CREDENTIALING (CREDENTIALING MANAGER)
(602) 609-5255
Entity
Organization

Contact information

Practice address
2214 W LOS ARBOLES PL, CHANDLER, AZ 85224-2143
(480) 340-1236
Mailing address
PO BOX 8130, CHANDLER, AZ 85246-8130
(480) 340-1236

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
106H00000X
Marriage & Family Therapist
Primary

Other

Enumeration date
06/06/2023
Last updated
06/06/2023
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