Organization
FULL BLOSSOM BEHAVIORAL HEALTH CONSULTANTS, LLC
Active
Organization
FULL BLOSSOM BEHAVIORAL HEALTH CONSULTANTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUANITA ELIZABETH BRIGMAN ED.D., LCSW (CEO)
(888) 310-8388
Entity
Organization
Contact information
Practice address
125 TOWNPARK DR NW, 300, KENNESAW, GA 30144-5803
(888) 310-8388
(888) 310-8388
Mailing address
125 TOWNPARK DR NW, 300, KENNESAW, GA 30144-5803
(888) 310-8388
(888) 310-8388
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW004925
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780009217
NPPES
GA
Enumeration date
07/11/2016
Last updated
07/11/2016
Update your record
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