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General NPI Number Information
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NPI Number | 1104775873
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Entity Type | Organization
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Legal Business Name | WILDFLOWER BEHAVIORAL THERAPY
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Dates
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Enumeration Date | 01/26/2026
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Last Update Date | 02/13/2026
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Provider Practice Location Address
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Address Line | 56249 BUFFLEHEAD RD
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City | BEND
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State | OR
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Zip | 97707-2102
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Country | US
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Telephone | 458-600-8730
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Fax |
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Provider Business Mailing Address
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Address Line | 56249 BUFFLEHEAD RD
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City | BEND
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State | OR
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Zip | 97707-2102
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER, BCBA
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Name | JORDAN RUTH REED
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Credential | BCBA, LBA, MA
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Telephone | 610-306-7054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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