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General NPI Number Information
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NPI Number | 1952267007
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Entity Type | Organization
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Legal Business Name | BLOOM
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Dates
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Enumeration Date | 01/02/2026
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 900B S WALTON BLVD STE 1B
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City | BENTONVILLE
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State | AR
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Zip | 72712-6360
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Country | US
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Telephone | 870-489-7934
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Fax |
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Provider Business Mailing Address
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Address Line | 8 SMALLEY LN
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City | BELLA VISTA
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State | AR
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Zip | 72715-4940
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Country | US
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Telephone | 870-489-7934
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Fax | 844-692-4102
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | LAUREN MINCY
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Credential | M.S. CCC-SLP
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Telephone | 870-489-7934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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