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General NPI Number Information
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NPI Number | 1457170680
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Entity Type | Organization
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Legal Business Name | BLOOMING MINDS THERAPY
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Dates
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Enumeration Date | 10/04/2024
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Last Update Date | 10/04/2024
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Provider Practice Location Address
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Address Line | 2926 BARKER CYPRESS RD APT 5211
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City | HOUSTON
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State | TX
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Zip | 77084-7939
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Country | US
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Telephone | 713-598-1566
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Fax |
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Provider Business Mailing Address
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Address Line | 2926 BARKER CYPRESS RD APT 5211
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City | HOUSTON
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State | TX
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Zip | 77084-7939
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Country | US
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Telephone | 713-598-1566
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | IVETTE HERNANDEZ
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Credential | CCC-SLP
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Telephone | 713-598-1566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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