| South Orange Blossoms, Llc | |
|
467 Springfield Ave Ste 205 Summit NJ 07901-2622 | |
| (973) 370-5686 | |
| Not Available |
| Full Name | South Orange Blossoms, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 467 Springfield Ave Ste 205, Summit, New Jersey |
| Authorized Official Name and Position | Jennifer Burleson (OWNER/PSYCHOTHERAPIST) |
| Authorized Official Contact | 9733705686 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Orange Blossoms, Llc 467 Springfield Ave Ste 205 Summit NJ 07901-2622 Ph: (973) 370-5686 | South Orange Blossoms, Llc 467 Springfield Ave Ste 205 Summit NJ 07901-2622 Ph: (973) 370-5686 |
| NPI Number | 1063985679 |
|---|---|
| Provider Enumeration Date | 01/07/2019 |
| Last Update Date | 04/13/2021 |
| Certification Date | 04/13/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063985679 | NPI | - | NPPES |
| 1881983633 | Other | NPI TYPE 1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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