Provider Demographics
NPI:1104646652
Name:PLAY AND BLOOM THERAPY SERVICES
Entity type:Organization
Organization Name:PLAY AND BLOOM THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:602-501-4056
Mailing Address - Street 1:11851 N 51ST AVE STE C140
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85304-2838
Mailing Address - Country:US
Mailing Address - Phone:602-316-6777
Mailing Address - Fax:
Practice Address - Street 1:11851 N 51ST AVE STE C140
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85304-2838
Practice Address - Country:US
Practice Address - Phone:602-316-6777
Practice Address - Fax:602-801-2555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-10
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty