Bloom Speech & Neuro Rehab, LLC
Organization Active NPI Hearing and Speech Clinic/Center · Jenks, OK
NPI 1730075474 · NPPES record last updated Jun 17, 2025
Key facts
- NPI
- 1730075474
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Hearing and Speech Clinic/Center 261QH0700X
- Legal business name
- BLOOM SPEECH & NEURO REHAB, LLC
- Practice address
- 9422 S Elwood Ave Ste 100
Jenks, OK 74037-2317 - Phone
- (918) 869-6379
- Fax
- (918) 627-7896
- NPI assigned
- Jun 17, 2025
- Organization subpart
- No
Authorized official
- Name
- Ashlie Nidiffer-Tull, MA., CCC-SLP
- Title
- Owner and SLP
- Phone
- (918) 869-6379
Practitioners 1
-
Ashlie Whitten, SLP
National Provider Directory
Locations
9422 S Elwood Ave
Ste 100
Jenks, OK 74037
Phone (918) 869-6379
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hearing and Speech Clinic/Center | 261QH0700X | Yes |
Addresses
Primary practice location
9422 S Elwood Ave Ste 100
Jenks, OK 74037-2317
Mailing address
9422 S Elwood Ave Ste 100
Jenks, OK 74037-2317
Phone (918) 869-6379
Other practice location 1
13400 S Maple St
Glenpool, OK 74033-2310
Phone (918) 869-6379
Other providers in Jenks, OK
- Sandeep K Bhatia
- Jayden Victoria Blackwell
- Casey Blair
- Mycah Blanton
- Bloom School Based Therapy
- Blooming Mind PLLC
- Blue Lotus Therapeutic Services, PC
- Megan Bosch
- Crystal Michelle Bowen
- Gwendolyn Ann Boyd
All providers in Jenks, OK · Hearing and Speech Clinic/Center in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.