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Organization
BLUE BALLOON AZ LLC
Active
Organization
BLUE BALLOON AZ LLC
Active
Other names
Blue Balloon ABA
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID SUSSMAN (MEMBER)
(201) 216-9500
Entity
Organization
Contact information
Practice address
175 BELGROVE DR, KEARNY, NJ 07032-1507
(551) 302-0306
Mailing address
175 BELGROVE DR, KEARNY, NJ 07032-1507
(551) 302-0306
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
11/04/2022
Last updated
11/04/2022
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