Organization
BLOSSOM COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA ELAINE KUNTZ LPC, NCC (OWNER/COUNSELOR)
(208) 991-0136
Entity
Organization
Contact information
Practice address
6015 OVERLAND RD, SUITE 104, BOISE, ID 83709-3014
(208) 991-0136
Mailing address
6015 OVERLAND RD, SUITE 104, BOISE, ID 83709-3014
(208) 991-0136
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LPC-4611
ID
Other
Enumeration date
01/17/2012
Last updated
01/17/2012
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