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General NPI Number Information
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NPI Number | 1427930700
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Entity Type | Organization
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Legal Business Name | LETS GROW ABA
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Dates
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Enumeration Date | 07/25/2025
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 4090 SW 46TH LN
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City | BUSHNELL
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State | FL
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Zip | 33513-4122
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Country | US
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Telephone | 352-406-9638
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Fax |
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Provider Business Mailing Address
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Address Line | 4090 SW 46TH LN
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City | BUSHNELL
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State | FL
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Zip | 33513-4122
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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 | BEHAVIOR ANALYST
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Name | STACEY BASS
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Credential |
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Telephone | 352-406-9638
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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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