Organization
SPEECH BLOSSOMS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA ANN TAYLOR MS CCC-SLP (OWNER / PROVIDER)
(208) 547-7145
Entity
Organization
Contact information
Practice address
1448 E CENTER ST STE G, POCATELLO, ID 83201-4132
(208) 547-7145
(844) 671-7145
Mailing address
1448 E CENTER ST STE I, POCATELLO, ID 83201-4132
(208) 547-7145
(844) 671-7145
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
SLP-1548
ID
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285125203
—
ID
Enumeration date
05/24/2018
Last updated
12/18/2023
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