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General NPI Number Information
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NPI Number | 1245828417
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Entity Type | Organization
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Legal Business Name | NURTURED ALLIANCE COUNSELING LLC
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Dates
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Enumeration Date | 01/04/2021
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Last Update Date | 01/04/2021
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Provider Practice Location Address
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Address Line | 2012 CHERRY HILL DR STE OFFICED
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City | COLUMBIA
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State | MO
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Zip | 65203-5882
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Country | US
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Telephone | 573-239-1944
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Fax |
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Provider Business Mailing Address
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Address Line | 5449 W DRISKEL RD
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City | COLUMBIA
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State | MO
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Zip | 65202-9117
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Country | US
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Telephone | 573-239-1944
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HARLY MICHELLE BLUMHAGEN
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Credential | LCSW
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Telephone | 573-239-1944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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