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Organization
BLOSSOM BEHAVIORAL SERVICES LLC
Active
Organization
BLOSSOM BEHAVIORAL SERVICES LLC
Active
Other names
Success on the Spectrum
Organization subpart
No
Provider details
NPI number
Authorized official
TELMA SUARES BCBA (OWNER)
(954) 882-2142
Entity
Organization
Contact information
Practice address
4263 NEVADA ST, AVE MARIA, FL 34142-5028
(954) 882-2142
Mailing address
4263 NEVADA ST, AVE MARIA, FL 34142-5028
(954) 882-2142
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
225X00000X
Occupational Therapist
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
Other
Enumeration date
05/26/2021
Last updated
05/26/2021
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