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General NPI Number Information
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NPI Number | 1225853799
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Entity Type | Organization
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Legal Business Name | BLOOM THERAPY SERVICES, LLC
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Dates
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Enumeration Date | 11/20/2024
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 5639 ELMORE RD
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City | ELMORE
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State | AL
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Zip | 36025-1605
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Country | US
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Telephone | 334-478-3350
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Fax | 334-478-3261
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Provider Business Mailing Address
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Address Line | 5639 ELMORE RD
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City | ELMORE
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State | AL
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Zip | 36025-1605
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Country | US
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Telephone | 334-478-3350
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Fax | 334-478-3261
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Authorized Official
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Title or Position | OWNER
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Name | KELLY DAVIS HARPER
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Credential | MS, CCC-SLP
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Telephone | 334-478-3350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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