Organization
BLOSSOM THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUTUMN ISAIAH PIERCE LCPC (OWNER)
(208) 614-0908
Entity
Organization
Contact information
Practice address
320 11TH AVE S STE 204, NAMPA, ID 83651-5074
(208) 614-0908
Mailing address
2316 SUNNYBROOK DR APT 304, NAMPA, ID 83686-6471
(208) 614-0908
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/08/2024
Last updated
04/08/2024
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