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General NPI Number Information
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NPI Number | 1871855577
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Entity Type | Organization
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Legal Business Name | ELIZABETH A BLOSSER, LLC
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Dates
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Enumeration Date | 06/09/2012
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Last Update Date | 07/07/2012
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Provider Practice Location Address
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Address Line | 6797 N HIGH ST STE 212
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City | WORTHINGTON
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State | OH
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Zip | 43085-2533
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Country | US
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Telephone | 614-505-7455
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Fax |
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Provider Business Mailing Address
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Address Line | 6797 N HIGH ST STE 212
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City | WORTHINGTON
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State | OH
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Zip | 43085-2533
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Country | US
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Telephone | 614-505-7455
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Fax |
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Authorized Official
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Title or Position | PROFESSIONAL CLINICAL COUNSELOR
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Name | ELIZABETH ANN BLOSSER
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Credential | PCC
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Telephone | 614-230-7374
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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 | E.0600569
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License Number State | OH
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