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General NPI Number Information
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NPI Number | 1710794300
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Entity Type | Organization
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Legal Business Name | BALANCE AND BLOOM THERAPY, LLC
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Dates
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Enumeration Date | 12/17/2024
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 26220 CENTER RIDGE RD
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City | WESTLAKE
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State | OH
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Zip | 44145-4016
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Country | US
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Telephone | 440-782-1730
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Fax |
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Provider Business Mailing Address
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Address Line | 337 CAMBRIDGE AVE
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City | ELYRIA
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State | OH
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Zip | 44035-6451
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Country | US
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Telephone | 216-978-0703
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GABRIELLE RAMIREZ
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Credential | MSW, LISW
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Telephone | 216-978-0703
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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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