Organization
BLAZE ABA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAWENN DORGILE BCBA (OWNER/BCBA)
(239) 465-8663
Entity
Organization
Contact information
Practice address
30192 ARMENIA RD, LEESBURG, FL 34748-8454
(239) 465-8663
Mailing address
30192 ARMENIA RD, LEESBURG, FL 34748-8454
(239) 465-8663
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
09/13/2024
Last updated
09/13/2024
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