| Bloom Behavioral Connections Llc | |
|
1500 Chestnut Street Suite 2 #2545 Philadelphia PA 19102 | |
| (267) 467-6599 | |
| Not Available |
| Full Name | Bloom Behavioral Connections Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1500 Chestnut Street, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Dana Sullivan (OWNER) |
| Authorized Official Contact | 7324534772 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloom Behavioral Connections Llc 1500 Chestnut Street Suite 2 #2545 Philadelphia PA 19102 Ph: (732) 453-4772 | Bloom Behavioral Connections Llc 1500 Chestnut Street Suite 2 #2545 Philadelphia PA 19102 Ph: (267) 467-6599 |
| NPI Number | 1902538333 |
|---|---|
| Provider Enumeration Date | 06/24/2022 |
| Last Update Date | 04/06/2023 |
| Certification Date | 04/03/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902538333 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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