Provider Demographics
NPI:1154113405
Name:BLOOM BRIDGE SPEECH THERAPY
Entity type:Organization
Organization Name:BLOOM BRIDGE SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SUMMER
Authorized Official - Middle Name:SINCLAIR
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:SLPD,CCC-SLP,CLC
Authorized Official - Phone:202-664-3664
Mailing Address - Street 1:124 WATERLOO CV
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-2177
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:124 WATERLOO CV
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-2177
Practice Address - Country:US
Practice Address - Phone:202-664-3664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health