Individual
KAYLA ANNE BLOOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Contact information
Practice address
1920 NC-54 STE 240, 360, DURHAM, NC 27713
(134) 091-9378
Mailing address
569 PANORAMA PARK PL, CARY, NC 27519-0858
(856) 466-1457
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-18006
NJ
Other
Enumeration date
04/17/2015
Last updated
12/20/2024
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