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Organization
BLOOM BEHAVIOR SERVICES LLC
Active
Organization
BLOOM BEHAVIOR SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SALLY MARIE LAVIGNE BCBA (OWNER/BCBA)
(573) 480-0440
Entity
Organization
Contact information
Practice address
910 W 14TH ST STE 230, WASHINGTON, MO 63090-7003
(573) 480-0440
Mailing address
901 W 14TH ST STE 230, WASHINGTON, MO 63090-4198
(636) 432-6709
(636) 432-1559
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
02/25/2021
Last updated
01/22/2025
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