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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
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