Organization
WILD BLOOM SPEECH AND LANGUAGE THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATIE BRELLENTHIN (SPEECH-LANGUAGE PATHOLOGIST)
(952) 381-7410
Entity
Organization
Contact information
Practice address
4385 COMANCHE DR APT 1, BOULDER, CO 80303-3670
(952) 381-7410
Mailing address
4385 COMANCHE DR APT 1, BOULDER, CO 80303-3670
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
04/14/2025
Last updated
04/14/2025
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