Healthcare Provider Details

I. General information

NPI: 1083543672
Provider Name (Legal Business Name): ALMA EN FLOR - SOUL IN BLOOM PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 BIRCH ST
LAKESIDE IA
50588-7720
US

IV. Provider business mailing address

110 BIRCH ST
LAKESIDE IA
50588-7720
US

V. Phone/Fax

Practice location:
  • Phone: 712-660-2258
  • Fax:
Mailing address:
  • Phone: 712-660-2258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JESSICA MOSIER
Title or Position: FOUNDER & CLINICAL DIRECTOR
Credential: LISW
Phone: 712-660-2258