Organization
BLOSSOM COUNSELING, CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASSIDY SHAIA LCSW (OWNER)
(801) 648-5730
Entity
Organization
Contact information
Practice address
11075 S STATE ST STE 14, SANDY, UT 84070-5194
(801) 648-5730
Mailing address
11075 S STATE ST STE 14, SANDY, UT 84070-5194
(801) 648-5730
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10837040-3501
NASW
UT
Enumeration date
03/10/2022
Last updated
03/10/2022
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