Organization
BLOSSOM PEDIATRIC SPEECH THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE WELENSKY MCD, CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST, OWNER)
(707) 559-8308
Entity
Organization
Contact information
Practice address
1796 NORTHSTAR DR, PETALUMA, CA 94954-6663
(707) 559-8308
Mailing address
1796 NORTHSTAR DR, PETALUMA, CA 94954-6663
(404) 643-7126
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
14047001
CA
Other
Enumeration date
12/21/2017
Last updated
12/31/2017
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