Healthcare Provider Details

I. General information

NPI: 1780526376
Provider Name (Legal Business Name): ASCEND AND BLOOM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5002 LOBLOLLY PL APT 306
LA PLATA MD
20646-9425
US

IV. Provider business mailing address

5002 LOBLOLLY PL APT 306
LA PLATA MD
20646-9425
US

V. Phone/Fax

Practice location:
  • Phone: 301-674-6508
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY CARSON
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential:
Phone: 301-674-6508