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Organization

BLOOMING BEHAVIOR THERAPY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANA LAURA TRUJILLO (OWNER)
(857) 247-1006
Entity
Organization

Contact information

Practice address
43 BARKLEY CIR STE 101, FORT MYERS, FL 33907-7517
(239) 800-9289
Mailing address
43 BARKLEY CIR STE 101, FORT MYERS, FL 33907-7517
(239) 800-9289

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
106E00000X
Assistant Behavior Analyst
106S00000X
Behavior Technician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
114740200
FL
Enumeration date
06/28/2022
Last updated
04/03/2025
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