Organization
BLOOM COUNSELING CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAURISA MAHAN LPC (COUNSELOR)
(580) 301-4709
Entity
Organization
Contact information
Practice address
2408 PAWNEE AVE, ALTUS, OK 73521-1520
(580) 301-4709
Mailing address
PO BOX 149, ALTUS, OK 73522-0149
(580) 301-4709
(888) 885-3449
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/19/2023
Last updated
07/19/2023
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