| Soul Blossom | |
|
2700 W 21st St Ste 25 Erie PA 16506-2972 | |
| (814) 602-4466 | |
| (814) 315-1016 |
| Full Name | Soul Blossom |
|---|---|
| Speciality | Counselor - Professional |
| Location | 2700 W 21st St Ste 25, Erie, Pennsylvania |
| Authorized Official Name and Position | Nea Elizabeth Motzer (OWNER) |
| Authorized Official Contact | 8146024466 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Soul Blossom 2700 W 21st St Ste 25 Erie PA 16506-2972 Ph: (814) 602-4466 | Soul Blossom 2700 W 21st St Ste 25 Erie PA 16506-2972 Ph: (814) 602-4466 |
| NPI Number | 1316431984 |
|---|---|
| Provider Enumeration Date | 06/18/2018 |
| Last Update Date | 06/18/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316431984 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | PC005433 (Pennsylvania) | Primary |
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