Provider Demographics
NPI:1780294322
Name:CONNECT & BLOOM SPEECH THERAPY INC.
Entity type:Organization
Organization Name:CONNECT & BLOOM SPEECH THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLIKSTEEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-326-1734
Mailing Address - Street 1:264 GOLF LINKS ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-5605
Mailing Address - Country:US
Mailing Address - Phone:509-499-1981
Mailing Address - Fax:
Practice Address - Street 1:264 GOLF LINKS ST
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-5605
Practice Address - Country:US
Practice Address - Phone:509-499-1981
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty