Organization
BLOSSOM PARK, LLC
Active
Other names
Blossom Park
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLETTE CARTER EDD (DIRECTOR)
(602) 769-6161
Entity
Organization
Contact information
Practice address
8535 E HARTFORD DR STE 206, SCOTTSDALE, AZ 85255-5444
(602) 535-8810
Mailing address
8535 E HARTFORD DR STE 206, SCOTTSDALE, AZ 85255-5444
(602) 535-8810
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
11/07/2018
Last updated
11/07/2018
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