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Organization

BLOOM THERAPY RESOURCES, LLC

Active
Other names
Play on Speech
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. TANIA LORELL RIFE M.A., CCC/SLP (SPEECH-LANGUAGE PATHOLOGIST)
(719) 373-3933
Entity
Organization

Contact information

Practice address
755 HIGHWAY 105, PALMER LAKE, CO 80133-9039
(719) 373-3933
(719) 434-9627
Mailing address
PO BOX 430, PALMER LAKE, CO 80133-0430
(719) 373-1010
(719) 434-9627

Taxonomy

Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
235Z00000X
Speech-Language Pathologist
SLP.0001003
CO
235Z00000X
Speech-Language Pathologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
73934283
CO
Enumeration date
05/03/2011
Last updated
01/15/2023
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