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General NPI Number Information
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NPI Number | 1225497530
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Entity Type | Organization
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Legal Business Name | THE BLUE BUTTERFLY ABA SERVICES LLC
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Dates
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Enumeration Date | 02/15/2016
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Last Update Date | 11/04/2016
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Provider Practice Location Address
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Address Line | 14851 STATE ROAD 52 UNIT 107 SUITE 192
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City | HUDSON
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State | FL
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Zip | 34669-4061
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Country | US
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Telephone | 701-213-2870
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Fax |
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Provider Business Mailing Address
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Address Line | 14851 STATE ROAD 52 UNIT 107 SUITE 192
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City | HUDSON
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State | FL
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Zip | 34669-4061
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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 | PRESIDENT
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Name | PRISCILLA GAGNE
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Credential | BCBA, LBA
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Telephone | 701-213-2870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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