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Contact Information

BLOSSOM SERVICES GROUP LLC
1042 14TH AVE E STE 210
WEST FARGO, ND58078-3363
 Phone: 701-541-9884
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Intellectual & Developmental Disabilities

103TM1800X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for BLOSSOM SERVICES GROUP LLC · (Female)

NPI # 1104790989
Status Active
Credentials
Entity Individual
Enumeration date 10/03/2025
Last updated 10/03/2025 - About 8 months ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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