Organization
BLOOMING SPEECH & LANGUAGE THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY M. REED M.A. CCC-SLP (MANAGING MEMBER / SLP)
(904) 260-0979
Entity
Organization
Contact information
Practice address
10350 BIG TREE LN, JACKSONVILLE, FL 32257-6347
(904) 260-0979
(904) 239-3216
Mailing address
10350 BIG TREE LN, JACKSONVILLE, FL 32257-6347
(904) 260-0979
(904) 239-3216
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
FL
235Z00000X
Speech-Language Pathologist
Primary
SA8105
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
889046300
—
FL
Enumeration date
07/08/2009
Last updated
07/08/2009
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