Healthcare Provider Details

I. General information

NPI: 1922903202
Provider Name (Legal Business Name): BLOOM AND GROW PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 RIDGEWOOD RD SUITE #100
WYOMISSING PA
19610
US

IV. Provider business mailing address

2669 SHILLINGTON RD STE 134
READING PA
19608-1758
US

V. Phone/Fax

Practice location:
  • Phone: 484-971-4730
  • Fax: 610-673-0323
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL

VIII. Authorized Official

Name: REBECCA ANN MALFARO
Title or Position: OWNER
Credential: CRNP
Phone: 484-971-4730