MEDICARE: BRAGG & BLOOM THERAPY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1093600306
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRAGG & BLOOM THERAPY, LLC

Provider Business Mailing Address
First Line	:	1759 E EDDINGTON ST
Second Line	:
City	:	NAMPA
State	:	ID
Zip	:	83686-4867
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1759 E EDDINGTON ST
Second Line	:
City	:	NAMPA
State	:	ID
Zip	:	83686-4867
Country	:	US
Telephone Number	:	503-351-3217
Fax Number	:

Authorized Official
Title or Position	:	OWNER/SPEECH-LANGUAGE PATHOLOGIST
Name	:	HANNAH BRAGG
Credential	:	M.S. CCC-SLP
Telephone Number	:	503-351-3217

Provider Enumeration Date	:	06/09/2025
Last Update Date	:	07/07/2025

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Directions to “BRAGG & BLOOM THERAPY, LLC ” Practice Location

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