Healthcare Provider Details

I. General information

NPI: 1265378038
Provider Name (Legal Business Name): BLOOMING BUTTERFLIES THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2655 S RAINBOW BLVD STE 100
LAS VEGAS NV
89146-5100
US

IV. Provider business mailing address

2655 S RAINBOW BLVD STE 100
LAS VEGAS NV
89146-5100
US

V. Phone/Fax

Practice location:
  • Phone: 702-726-9722
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: ANN UGANIZA
Title or Position: OFFICE MANAGER
Credential:
Phone: 702-726-9722