Provider Demographics
NPI:1013631282
Name:BLOOMING MINDS THERAPY
Entity type:Organization
Organization Name:BLOOMING MINDS THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATTI
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:989-295-0397
Mailing Address - Street 1:218 VILLAGE GREEN BLVD APT 101
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-3608
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:218 VILLAGE GREEN BLVD APT 101
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-3608
Practice Address - Country:US
Practice Address - Phone:567-281-7525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty