| Soul Blossom Llc | |
|
2700 W 21st St Ste 3 Erie PA 16506-6915 | |
| (814) 602-4466 | |
| Not Available |
| Full Name | Soul Blossom Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 2700 W 21st St Ste 3, Erie, Pennsylvania |
| Authorized Official Name and Position | Nea Elizabeth Motzer (PRESIDENT) |
| Authorized Official Contact | 8146024466 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Soul Blossom Llc 2700 W 21st St Ste 3 Erie PA 16506-6915 Ph: (814) 602-4466 | Soul Blossom Llc 2700 W 21st St Ste 3 Erie PA 16506-6915 Ph: (814) 602-4466 |
| NPI Number | 1164284030 |
|---|---|
| Provider Enumeration Date | 01/26/2024 |
| Last Update Date | 02/02/2024 |
| Certification Date | 02/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164284030 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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