Organization
BLOSSOM THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN LEA WICKLIFFE M.S.P., CCC-SLP (OWNER)
(864) 918-3195
Entity
Organization
Contact information
Practice address
23 ROCK CREEK DR, GREENVILLE, SC 29605-1123
(864) 918-3195
Mailing address
23 ROCK CREEK DR, GREENVILLE, SC 29605-1123
(864) 918-3195
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
07/13/2020
Last updated
07/13/2020
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