| Blue Gems Aba Az Llc | |
|
1120 W University Ave Fl 2 Flagstaff AZ 86001-2851 | |
| (602) 844-4820 | |
| Not Available |
| Full Name | Blue Gems Aba Az Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1120 W University Ave Fl 2, Flagstaff, Arizona |
| Authorized Official Name and Position | David Wolf (CEO) |
| Authorized Official Contact | 6172977998 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Gems Aba Az Llc 101 Eisenhower Pkwy Ste 300 Roseland NJ 07068-1054 Ph: (617) 297-7998 | Blue Gems Aba Az Llc 1120 W University Ave Fl 2 Flagstaff AZ 86001-2851 Ph: (602) 844-4820 |
| NPI Number | 1013793231 |
|---|---|
| Provider Enumeration Date | 09/04/2023 |
| Last Update Date | 07/18/2024 |
| Certification Date | 07/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013793231 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Secondary |
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