Organization
BLOSSOM FAMILY THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHACOYA GHRAHAM (OWNER)
(980) 297-8237
Entity
Organization
Contact information
Practice address
13420 REESE BLVD W, HUNTERSVILLE, NC 28078-7925
(980) 297-8237
(704) 887-9496
Mailing address
13420 REESE BLVD W, HUNTERSVILLE, NC 28078-7925
(980) 297-8237
(704) 887-9496
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/03/2025
Last updated
05/27/2025
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