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General NPI Number Information
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NPI Number | 1063399210
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Entity Type | Organization
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Legal Business Name | BOHEME HOLISTIC CLINICAL SERVICES
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Dates
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Enumeration Date | 08/19/2025
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 110 S COURT ST FL 3
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City | SCOTTSVILLE
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State | KY
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Zip | 42164-1422
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Country | US
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Telephone | 270-238-2085
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Fax |
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Provider Business Mailing Address
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Address Line | 86 OLIVER ST
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City | SCOTTSVILLE
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State | KY
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Zip | 42164-8730
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Country | US
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Telephone | 270-238-2085
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | VANESSA SEWELL
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Credential | LPCC
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Telephone | 270-238-2085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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