Organization
BLOOM THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAKEDRA J RODGERS (OWNER)
(334) 357-9183
Entity
Organization
Contact information
Practice address
6958 BRIGHTWELL LN, DORA, AL 35062-2613
(334) 357-9183
Mailing address
4124 WATERMELON RD STE B, NORTHPORT, AL 35473-5252
(334) 357-9183
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/15/2022
Last updated
09/19/2024
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