Organization
BLOSSOM INTEGRATED HEALTH AND BEHAVIORAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IHUOMA MARVELOUS UDEAGHA DNP, PMHNP-BC, FNP-C (CHIEF EXECUTIVE OFFICER)
(240) 490-4242
Entity
Organization
Contact information
Practice address
338 MILL ST, HAGERSTOWN, MD 21740-6138
(240) 347-4494
(240) 347-4495
Mailing address
338 MILL ST, HAGERSTOWN, MD 21740-6138
(340) 347-4494
(240) 347-4495
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
05/10/2023
Last updated
04/26/2024
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