Organization
CLUB SPECTRUM ABA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORI-ANNE BONFILIO BCBA (FOUNDER CEO)
(407) 369-3788
Entity
Organization
Contact information
Practice address
3700 CURRY FORD RD APT M8, ORLANDO, FL 32806-2641
(407) 369-3788
Mailing address
3700 CURRY FORD RD APT M8, ORLANDO, FL 32806-2641
(407) 369-3788
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
05/08/2022
Last updated
05/08/2022
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