Organization
SPECTRUM SPROUTS ABA THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGINALD BULLOCK (EXECUTIVE DIRECTOR)
(267) 808-5801
Entity
Organization
Contact information
Practice address
5811 GERMANTOWN AVE, PHILADELPHIA, PA 19144-2138
(267) 808-5801
Mailing address
5811 GERMANTOWN AVE, PHILADELPHIA, PA 19144-2138
Taxonomy
Speciality
Code
Description
License number
State
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
Primary
—
—
Other
Enumeration date
03/13/2026
Last updated
03/13/2026
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