Provider Demographics
NPI:1194400978
Name:LET IT BLOOM MENTAL HEALTH LLC
Entity type:Organization
Organization Name:LET IT BLOOM MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR / PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:YESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:PALMA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:702-524-9966
Mailing Address - Street 1:7617 BROCADE CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-0456
Mailing Address - Country:US
Mailing Address - Phone:702-524-9966
Mailing Address - Fax:
Practice Address - Street 1:7617 BROCADE CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-0456
Practice Address - Country:US
Practice Address - Phone:702-524-9966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health