Provider Demographics
NPI:1861211492
Name:UME BLOSSOM THERAPY LLC
Entity type:Organization
Organization Name:UME BLOSSOM THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:BEER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:319-213-5164
Mailing Address - Street 1:7112 COUNTRY RIDGE DR NW
Mailing Address - Street 2:
Mailing Address - City:PALO
Mailing Address - State:IA
Mailing Address - Zip Code:52324-7014
Mailing Address - Country:US
Mailing Address - Phone:319-213-5164
Mailing Address - Fax:
Practice Address - Street 1:7112 COUNTRY RIDGE DR NW
Practice Address - Street 2:
Practice Address - City:PALO
Practice Address - State:IA
Practice Address - Zip Code:52324-7014
Practice Address - Country:US
Practice Address - Phone:319-213-5164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty