Organization
BLOOM SPEECH & LANGUAGE THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAYLOR BLEDSOE (OWNER)
(409) 659-2076
Entity
Organization
Contact information
Practice address
115 HIGHWAY 326 S, SOUR LAKE, TX 77659-7871
(409) 659-2076
Mailing address
PO BOX 310, NOME, TX 77629-0310
(409) 659-2076
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
Other
Enumeration date
08/12/2024
Last updated
10/31/2024
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