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General NPI Number Information
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NPI Number | 1669121067
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Entity Type | Organization
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Legal Business Name | PLAY AND BLOOM THERAPY
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Dates
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Enumeration Date | 03/22/2022
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Last Update Date | 08/18/2022
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Provider Practice Location Address
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Address Line | 41 ORCHARD TER
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City | WINOOSKI
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State | VT
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Zip | 05404-1314
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Country | US
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Telephone | 505-917-4161
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Fax |
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Provider Business Mailing Address
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Address Line | 25 SUMMER ST
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City | MONTPELIER
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State | VT
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Zip | 05602-2228
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Country | US
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Telephone | 505-917-4161
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Fax |
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Authorized Official
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Title or Position | OWNER AND PROVIDER
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Name | HANNAH BLOOM
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Credential | MOTR/L
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Telephone | 505-917-4161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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