Organization
IN BLOOM ABA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER CONRAD-SMITH BCBA (OWNER/MANAGER)
(931) 249-5286
Entity
Organization
Contact information
Practice address
3142 WHITETAIL DR, CLARKSVILLE, TN 37043
(931) 249-5286
Mailing address
3142 WHITETAIL DR, CLARKSVILLE, TN 37043
(931) 249-5286
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
01/16/2021
Last updated
01/16/2021
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