Provider Demographics
NPI:1801512868
Name:BLUME KIDS THERAPY, LLC
Entity type:Organization
Organization Name:BLUME KIDS THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:RANSDELL
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTR/L
Authorized Official - Phone:303-620-6987
Mailing Address - Street 1:2716 WINDING TRAIL PL
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-1412
Mailing Address - Country:US
Mailing Address - Phone:303-620-6987
Mailing Address - Fax:
Practice Address - Street 1:2716 WINDING TRAIL PL
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-1412
Practice Address - Country:US
Practice Address - Phone:303-620-6987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-12
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty