Organization
BLUE BALLOON AZ LLC
Active
Other names
Blue Balloon ABA
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID SUSSMAN (MEMBER)
(201) 216-9500
Entity
Organization
Contact information
Practice address
175 BELGROVE DR, KEARNY, NJ 07032-1507
(551) 302-0306
Mailing address
175 BELGROVE DR, KEARNY, NJ 07032-1507
(551) 302-0306
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
11/04/2022
Last updated
11/04/2022
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