Organization
BLOOM ABA THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA LANE (OWNER)
(518) 366-9675
Entity
Organization
Contact information
Practice address
201 QUAKER LN, DELANSON, NY 12053-2833
(518) 366-9675
Mailing address
201 QUAKER LN, DELANSON, NY 12053-2833
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/01/2022
Last updated
09/01/2022
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