| Blossom Behavior Consulting | |
|
620 Clearview Dr Charleston SC 29412-4544 | |
| (305) 394-9379 | |
| Not Available |
| Full Name | Blossom Behavior Consulting |
|---|---|
| Speciality | Behavior Analyst |
| Location | 620 Clearview Dr, Charleston, South Carolina |
| Authorized Official Name and Position | Gretchen Bentz Fricker (BEHAVIOR ANALYST) |
| Authorized Official Contact | 3053949379 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blossom Behavior Consulting 620 Clearview Dr Charleston SC 29412-4544 Ph: () - | Blossom Behavior Consulting 620 Clearview Dr Charleston SC 29412-4544 Ph: (305) 394-9379 |
| NPI Number | 1295259133 |
|---|---|
| Provider Enumeration Date | 08/02/2017 |
| Last Update Date | 08/02/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295259133 | NPI | - | NPPES |
| NONE | Other | NONE | |
| PENDING | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Secondary |
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