Organization
BLOOMKIDZ INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL SCOTT FEAVEL (CEO)
(928) 853-6052
Entity
Organization
Contact information
Practice address
2141 E PECOS RD, CHANDLER, AZ 85225-6077
(480) 846-0607
(480) 841-6696
Mailing address
2141 E PECOS RD, CHANDLER, AZ 85225-6077
(480) 846-0607
(480) 841-6696
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
2251P0200X
Pediatric Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155000
—
AZ
01
—
BH9666
ARIZONA DEPARTMENT OF HEALTH SERVICES
AZ
01
—
OTC13281
ARIZONA DEPARTMENTS OF HEALTH SERVICES
AZ
Enumeration date
03/15/2022
Last updated
03/18/2024
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