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General NPI Number Information
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NPI Number | 1922956945
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Entity Type | Organization
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Legal Business Name | JACQUELINE M BRIDEAU, PLLC DBA BLOOM AND GROW PEDIATRIC PHYSICAL THERAPY
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Dates
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Enumeration Date | 03/17/2026
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Last Update Date | 03/17/2026
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Provider Practice Location Address
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Address Line | 2104 WINDSOR RD
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City | ALEXANDRIA
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State | VA
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Zip | 22307-1016
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Country | US
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Telephone | 703-829-7356
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Fax |
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Provider Business Mailing Address
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Address Line | 2104 WINDSOR RD
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City | ALEXANDRIA
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State | VA
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Zip | 22307-1016
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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, PHYSICAL THERAPIST
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Name | DR. JACQUELINE BRIDEAU
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Credential | PT
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Telephone | 703-946-6494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State |
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