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Organization

THERABLOOM, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CAROLYN LUCKETT MS, CCC-SLP (SLP/OWNER)
(260) 437-8918
Entity
Organization

Contact information

Practice address
6376 CLORE LN, CRESTWOOD, KY 40014-8042
(260) 437-8918
Mailing address
9462 BROWNSBORO RD # 102, LOUISVILLE, KY 40241-1118
(260) 437-8918

Taxonomy

Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100369150
KY
Enumeration date
01/09/2025
Last updated
01/09/2025
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