# BORN TO BLOSSOM LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255066163
- **Authorized official:** MRS. ALEXANDRIA WILBERT BCBA, LBA, LMLP (OWNER/CEO)
- **Authorized official phone:** (417) 540-7259

## Contact information

- **Practice address:** 1141 MILITARY AVE, BAXTER SPRINGS, KS 66713-1509
- **Practice address phone:** (620) 330-9036
- **Practice address fax:** (620) 206-2514
- **Mailing address:** 1141 MILITARY AVE, BAXTER SPRINGS, KS 66713-1509
- **Mailing address phone:** (620) 330-9036
- **Mailing address fax:** (620) 206-2514

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 103K00000X | Behavior Analyst | — | NULL | Yes |
| 103K00000X | Behavior Analyst | — | — | Yes |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 106E00000X | Assistant Behavior Analyst | — | NULL | — |
| 106E00000X | Assistant Behavior Analyst | — | — | — |
| 106S00000X | Behavior Technician | — | NULL | — |
| 106S00000X | Behavior Technician | — | — | — |

## Other

- **Enumeration date:** 07/24/2022
- **Last updated:** 02/12/2026