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Organization
IMAGINE BLUE ABA
Active
Organization
IMAGINE BLUE ABA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAYLI M GERARD BCBA (OWNER)
(561) 761-9120
Entity
Organization
Contact information
Practice address
5426 WINDBRUSH DR, TAMPA, FL 33625-4050
(813) 713-1161
Mailing address
5426 WINDBRUSH DR, TAMPA, FL 33625-4050
(813) 713-1161
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
02/07/2024
Last updated
02/07/2024
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