Organization
BEHAVIOR BLOSSOMS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN KINDY (CFO)
(407) 342-7939
Entity
Organization
Contact information
Practice address
355 N KEPLER RD, DELAND, FL 32724-4713
(407) 342-7939
(888) 808-5278
Mailing address
151 W CHURCH AVE, LONGWOOD, FL 32750-4105
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018050303
—
FL
Enumeration date
12/20/2021
Last updated
12/20/2021
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