Organization
BLOOM THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABIGAIL LANE LPC (THERAPIST/OWNER)
(307) 214-0229
Entity
Organization
Contact information
Practice address
1616 E 19TH ST STE 3, CHEYENNE, WY 82001-4946
(307) 214-0229
Mailing address
1616 E 19TH ST STE 3, CHEYENNE, WY 82001-4946
(307) 214-0229
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/29/2024
Last updated
02/15/2024
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