| Bloom Pediatric Therapy, Llc | |
|
109 Lane Park Dr, Maylene, AL 35114-6085 | |
| (205) 919-2134 | |
| Not Available |
| Full Name | Bloom Pediatric Therapy, Llc |
|---|---|
| Type | Facility |
| Speciality | Speech-language Pathologist |
| Location | 109 Lane Park Dr, Maylene, Alabama |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831933761 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | (* (Not Available)) | Secondary |
| 235Z00000X | Speech-language Pathologist | (* (Not Available)) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Bloom Pediatric Therapy, Llc 109 Lane Park Dr, Maylene, AL 35114-6085 Ph: () - | Bloom Pediatric Therapy, Llc 109 Lane Park Dr, Maylene, AL 35114-6085 Ph: (205) 919-2134 |
Jessica Emmons Garzarek, MA, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 109 Lane Park Dr, Maylene, AL 35114 Phone: 205-547-1652 | |
Taylor Nichole Tidmore, MCD CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 109 Lane Park Dr, Maylene, AL 35114 Phone: 205-547-1652 Fax: 205-651-0134 |