Healthcare Provider Details

I. General information

NPI: 1003430802
Provider Name (Legal Business Name): JASON PRINZ BLUME BCBA, LBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2020
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1594 HENDERSONVILLE RD
ASHEVILLE NC
28803-3136
US

IV. Provider business mailing address

1594 HENDERSONVILLE RD
ASHEVILLE NC
28803-3136
US

V. Phone/Fax

Practice location:
  • Phone: 800-701-0498
  • Fax:
Mailing address:
  • Phone: 800-701-0498
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-89480
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: