Organization
BLOOM PSYCHOTHERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYLA JOHNSON LMHC (LICENSED MENTAL HEALTH COUNSELOR)
(774) 244-0598
Entity
Organization
Contact information
Practice address
3 HOLLY LN, WEST TISBURY, MA 02575-5316
(774) 244-0598
Mailing address
3 HOLLY LN, WEST TISBURY, MA 02575-5316
(774) 244-0598
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/26/2022
Last updated
08/26/2022
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