Desert Bloom Therapy | |
39325 Plymouth Rd Ste 202 Livonia MI 48150-4531 | |
(734) 404-5835 | |
Not Available |
Full Name | Desert Bloom Therapy |
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Speciality | Social Worker |
Location | 39325 Plymouth Rd Ste 202, Livonia, Michigan |
Authorized Official Name and Position | Katelin Zylka (OWNER) |
Authorized Official Contact | 2488929497 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Desert Bloom Therapy 16918 Comstock St Livonia MI 48154-1608 Ph: (248) 892-9497 | Desert Bloom Therapy 39325 Plymouth Rd Ste 202 Livonia MI 48150-4531 Ph: (734) 404-5835 |
NPI Number | 1073248993 |
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Provider Enumeration Date | 07/24/2022 |
Last Update Date | 12/28/2022 |
Certification Date | 12/28/2022 |
Medicare PECOS PAC ID | 8921478348 |
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Medicare Enrollment ID | O20221229002132 |
Identifier | Type | State | Issuer |
---|---|---|---|
1073248993 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
104100000X | Social Worker | (* (Not Available)) | Primary |
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
Provider Name | Katelin Zylka |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1942893870 PECOS PAC ID: 0749650166 Enrollment ID: I20221229002209 |
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