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Organization
BLOOMED
Active
Organization
BLOOMED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELIZABETH LEFEBRE (EXECUTIVE DIRECTOR)
(206) 914-9219
Entity
Organization
Contact information
Practice address
336 W 44TH ST, INDIANAPOLIS, IN 46208-3734
(206) 914-9219
Mailing address
336 W 44TH ST, INDIANAPOLIS, IN 46208-3734
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
10/20/2016
Last updated
10/20/2016
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