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Organization
BLUEVINE BEHAVIORAL THERAPY LLC
Active
Organization
BLUEVINE BEHAVIORAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YRALIA DEVEREUX (OWNER)
(208) 695-0098
Entity
Organization
Contact information
Practice address
427 N MAGNOLIA AVE, ORLANDO, FL 32801-1524
(407) 900-7422
Mailing address
14411 WABASSO LOOP, WINTER GARDEN, FL 34787-5797
(208) 695-0098
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
02/12/2024
Last updated
02/12/2024
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