Bloom Center for Pediatric Therapy, LLC

NPI #1215397666 in Pocatello, Idaho

Provider Information

NPI Number
1215397666
Entity Type
Organization
Organization Name
Bloom Center for Pediatric Therapy, LLC
Primary Specialty
Speech-Language Pathologist
Enumeration Date
Feb 27, 2016
Last Updated
Nov 22, 2025

Practice Location

Address
7677 W PORTNEUF RD
State
Idaho
ZIP Code
83204-7336
Phone
(208) 604-6260

Authorized Official

Name
MRS. MICHELLE LEE LANCE, M.S. CCC-SLP
Title
OWNER/SPEECH LANGUAGE PATHOLOGIST
Phone
(208) 604-6260

Specialties & Taxonomy Codes

Specialty
Occupational Therapist
Physical Therapist
Speech-Language Pathologist

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