Organization
BLOOM THERAPY AND WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA MARIE DORN MSW, LISW-CP (OWNER)
(920) 460-6834
Entity
Organization
Contact information
Practice address
120 GANTT ST STE 8, LEXINGTON, SC 29072-2811
(803) 470-4026
Mailing address
120 GANTT ST STE 8, LEXINGTON, SC 29072-2811
(803) 470-4026
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/16/2020
Last updated
07/28/2022
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