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General NPI Number Information
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NPI Number | 1194330639
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Entity Type | Organization
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Legal Business Name | BLOOM MARRIAGE AND FAMILY COUNSELING INC
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Dates
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Enumeration Date | 09/11/2020
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 27951 SMYTH DR STE 103
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City | VALENCIA
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State | CA
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Zip | 91355-4049
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Country | US
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Telephone | 661-992-4711
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Fax | 661-678-0711
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Provider Business Mailing Address
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Address Line | 27951 SMYTH DR STE 103
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City | VALENCIA
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State | CA
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Zip | 91355-4049
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Country | US
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Telephone | 661-992-4711
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Fax | 661-678-0711
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Authorized Official
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Title or Position | OWNER-PROVIDER
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Name | KAREN MALBON
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Credential | LMFT
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Telephone | 661-992-4711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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