Organization
BLUE LIGHT THERAPIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HANNAH NUR MOHAMED BCBA (CEO)
(469) 226-7516
Entity
Organization
Contact information
Practice address
421 E ROYAL LN SUITE 100, IRVING, TX 75039
(469) 226-7516
Mailing address
421 E ROYAL LN SUITE 100, IRVING, TX 75039
(469) 226-7516
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1386106623
NPI
—
Enumeration date
06/12/2020
Last updated
08/31/2022
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