NPI 1003643511 · live from the CMS NPI Registry
Blossom Aba Therapy Ut LLC
Behavior Analyst in Salt Lake City, UT. National Provider Identifier 1003643511, active.
NPI record
| NPI | 1003643511 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 2795 E Cottonwood Pkwy, Salt Lake City, UT 84121 |
| Practice phone | 732-730-7505 |
| Mailing address | 229 Route 70, Toms River, NJ 08755 |
| Enumerated | September 18, 2024 |
| Last updated | September 18, 2024 |
| Authorized official | Chad Kaufman, Ceo |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst primary | 103K00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.