Organization
IN FULL BLOOM COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA JOHNSON M.A. LPCC (OWNER)
(573) 271-0785
Entity
Organization
Contact information
Practice address
108 CAMELLIA DR, CAPE GIRARDEAU, MO 63703
(573) 271-0785
Mailing address
2780 NEW HOLT ROAD, STE D PMB #326, PADUCAH, KY 42001
(573) 271-0785
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/25/2023
Last updated
09/25/2023
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