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Mr. STANLEY SHANE BLOOM BCBA

Individual Provider (NPI-1) Active

Behavior Analyst

Provider Information

NPI Number
1093244782
Provider Type
Individual Provider (NPI-1)
Credentials
BCBA
Status
Active

Contact & Location

Address
98-939 MOANALUA RD, AIEA, HI, 967015012
Phone
(855) 223-7123

Specialties & Taxonomies

Behavior Analyst License: HI #1-20-42966
Behavior Analyst Primary License: HI #BA-433

All Addresses

LOCATION

98-939 MOANALUA RD

AIEA, HI, 967015012

(855) 223-7123

MAILING

PO BOX 33568

SAN DIEGO, CA, 921633568

(855) 223-7123