Organization
BLOOM AND GROW EARLY INTERVENTION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY DUCKWORTH (MEMBER)
(484) 432-1614
Entity
Organization
Contact information
Practice address
148 W STATE ST STE 103, KENNETT SQUARE, PA 19348-3055
(484) 432-1614
(610) 947-0405
Mailing address
212 CHINA CIR, WEST GROVE, PA 19390-8813
(484) 432-1614
(610) 947-0405
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
12/08/2021
Last updated
12/08/2021
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