Individual
JENSEN LEIGH BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
3175 SIENNA DR S STE 103, FARGO, ND 58104-8910
(701) 532-1906
(701) 532-1896
Mailing address
3156 BLUESTEM DR APT 110, WEST FARGO, ND 58078-3302
(701) 219-3705
(701) 532-1896
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2624
ND
Other
Enumeration date
05/28/2024
Last updated
09/29/2025
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