=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477406270
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BLOOM AND GROW COLLECTIVE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/19/2026
-----------------------------------------------------
Last Update Date | 02/19/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 208 W SPRING ST
-----------------------------------------------------
City | TITUSVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16354-1653
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-493-3063
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 208 W SPRING ST
-----------------------------------------------------
City | TITUSVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16354-1653
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-493-3063
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FOUNDER
-----------------------------------------------------
Name | SARAH A MUIR
-----------------------------------------------------
Credential | OTR/L
-----------------------------------------------------
Telephone | 814-493-3063
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------