NPI 1407546476 · live from the CMS NPI Registry
Bloom Aba
Behavior Analyst in Goose Creek, SC. National Provider Identifier 1407546476, active.
NPI record
| NPI | 1407546476 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 409 Clarine Dr, Goose Creek, SC 29445 |
| Practice phone | 336-918-6033 |
| Mailing address | 78 Folly Road Blvd Ste B9, Charleston, SC 29407 |
| Enumerated | May 11, 2023 |
| Last updated | July 16, 2026 |
| Authorized official | Breannah Davis-Bloom, Owner Operator |
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.