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General NPI Number Information
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NPI Number | 1124902986
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Entity Type | Organization
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Legal Business Name | AMANAH BLOOM COUNSELING AND CONSULTING
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Dates
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Enumeration Date | 08/04/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 3580 W INA RD STE 220
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City | TUCSON
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State | AZ
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Zip | 85741-2276
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Country | US
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Telephone | 520-675-4002
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Fax | 520-779-3234
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Provider Business Mailing Address
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Address Line | PO BOX 1028
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City | MARANA
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State | AZ
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Zip | 85653-1028
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Country | US
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Telephone | 520-591-3010
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEPHENIE KAMAAL
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Credential | LCSW
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Telephone | 520-591-3010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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