Organization
WILDERNESS BLOOMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTIN LEE TEMPLE LAC, LAMFT, M.ED (COUNSELOR)
(479) 352-3128
Entity
Organization
Contact information
Practice address
1500 MAIN ST, VAN BUREN, AR 72956-4731
(479) 352-3128
Mailing address
300 NW RED BARN CIR APT 212, BENTONVILLE, AR 72712-2498
(479) 352-3128
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
11/11/2021
Last updated
11/11/2021
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