Organization
BLOOM PEDIATRIC SPEECH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KASEY LYNN WICKBERG M.S. CCC-SLP (SPEECH LANGUAGE PATHOLOGIST)
(918) 527-5360
Entity
Organization
Contact information
Practice address
2000 NW 150TH ST, OKLAHOMA CITY, OK 73134-2004
(918) 527-5360
Mailing address
14820 MARBLELEAF DR, EDMOND, OK 73013-1468
(918) 527-5360
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
07/20/2026
Last updated
07/20/2026
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