Healthcare Provider Details

I. General information

NPI: 1689598393
Provider Name (Legal Business Name): BLOOM AND GROW ABA CO. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5448 THORNEY DR
HILLIARD OH
43026-7908
US

IV. Provider business mailing address

5448 THORNEY DR
HILLIARD OH
43026-7908
US

V. Phone/Fax

Practice location:
  • Phone: 440-773-1083
  • Fax:
Mailing address:
  • Phone: 440-773-1083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MRS. JOSIE LYNN GOLDSTEIN
Title or Position: BOARD CERTIFIED BEHAVIOR ANALYST
Credential: M.A., BCBA, COBA
Phone: 440-773-1083