| Blue Gems Aba Nc Llc | |
|
615 Saint George Square Ct Winston Salem NC 27103-1356 | |
| (336) 827-3384 | |
| (617) 340-3371 |
| Full Name | Blue Gems Aba Nc Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 615 Saint George Square Ct, Winston Salem, North Carolina |
| 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 Nc Llc 615 Saint George Square Ct Winston Salem NC 27103-1356 Ph: () - | Blue Gems Aba Nc Llc 615 Saint George Square Ct Winston Salem NC 27103-1356 Ph: (336) 827-3384 |
| NPI Number | 1861061699 |
|---|---|
| Provider Enumeration Date | 06/24/2021 |
| Last Update Date | 07/18/2024 |
| Certification Date | 07/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861061699 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Secondary |
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