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General NPI Number Information
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NPI Number | 1396638490
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Entity Type | Organization
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Legal Business Name | SEED TO BLOOM CREATIVE HEALING, LLC
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Dates
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Enumeration Date | 05/29/2025
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 1101 W CLAIREMONT AVE STE 2F
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City | EAU CLAIRE
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State | WI
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Zip | 54701-6161
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Country | US
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Telephone | 608-322-6929
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Fax | 608-322-6929
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Provider Business Mailing Address
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Address Line | 3711 JEFFERS RD
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City | EAU CLAIRE
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State | WI
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Zip | 54703-1489
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Country | US
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Telephone | 608-322-6929
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | TIFFANY ELIZABETH MOBERG
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Credential | LCSW
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Telephone | 608-322-6929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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