Organization
BLOOM PEDIATRIC THERAPY SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOCELYN JOHNSON (PRESIDENT)
(870) 919-3141
Entity
Organization
Contact information
Practice address
1007 WINDOVER RD STE A, JONESBORO, AR 72401-6009
(870) 520-0646
(870) 520-5034
Mailing address
1007 WINDOVER RD STE A, JONESBORO, AR 72401-6009
(870) 520-0646
(870) 520-5034
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
225X00000X
Occupational Therapist
Primary
OTR1436
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163120742
—
AR
Enumeration date
03/19/2007
Last updated
03/11/2026
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