Organization · NPI-2

Blossom Therapy LLC

Speech-Language Pathologist, · Lafayette, LA

NPI number1770472292
StatusActive
Last updated in NPPESOct 8, 2026

Details

NPI
1770472292
Entity type
Organization (NPI-2)
Legal business name
Blossom Therapy LLC
Organization subpart
No
Enumeration date
Jun 30, 2025
Certification date
Oct 8, 2026
Last updated
Oct 8, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
235Z00000X Speech-Language Pathologist,––Yes
225X00000X Occupational Therapist––

Practice location

315 S College Rd Ste 215
Lafayette, LA 70503-3213

Phone 337-264-2600 · Fax 337-451-0349

Mailing address

218 Beverly Dr
Lafayette, LA 70503-3108

Authorized official

Kelly Ann Leleux
Speech Therapist
7326182667

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