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General NPI Number Information
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NPI Number | 1922903202
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Entity Type | Organization
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Legal Business Name | BLOOM AND GROW PSYCHIATRY LLC
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Dates
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Enumeration Date | 10/08/2026
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Last Update Date | 10/08/2026
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Provider Practice Location Address
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Address Line | 2240 RIDGEWOOD RD SUITE #100
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City | WYOMISSING
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State | PA
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Zip | 19610
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Country | US
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Telephone | 484-971-4730
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Fax | 610-673-0323
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Provider Business Mailing Address
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Address Line | 2669 SHILLINGTON RD STE 134
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City | READING
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State | PA
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Zip | 19608-1758
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | REBECCA ANN MALFARO
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Credential | CRNP
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Telephone | 484-971-4730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State | NULL
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