Organization
BLOOMING MINDS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRISTINA C STILES SLP, MS, CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST)
(208) 713-3463
Entity
Organization
Contact information
Practice address
1034 N 3RD ST, SUITE 5B, COEUR D ALENE, ID 83814-3145
(208) 713-3463
Mailing address
1034 N 3RD ST, SUITE 5B, COEUR D ALENE, ID 83814-3145
(208) 713-3463
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-2231
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154671048
INDIVIDUAL NPI
—
01
—
1770954794
INDIVIDUAL NPI
—
Enumeration date
05/02/2015
Last updated
10/16/2015
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