| Freedom To Blossom | |
|
522 Kensington Park Dr Canton GA 30114-8828 | |
| (703) 867-2667 | |
| Not Available |
| Full Name | Freedom To Blossom |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 522 Kensington Park Dr, Canton, Georgia |
| Authorized Official Name and Position | Kayla Farabaugh (MEMBER) |
| Authorized Official Contact | 7038672667 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Freedom To Blossom 522 Kensington Park Dr Canton GA 30114-8828 Ph: (703) 867-2667 | Freedom To Blossom 522 Kensington Park Dr Canton GA 30114-8828 Ph: (703) 867-2667 |
| NPI Number | 1821725276 |
|---|---|
| Provider Enumeration Date | 08/05/2022 |
| Last Update Date | 08/05/2022 |
| Certification Date | 08/05/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821725276 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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