Blue Bridge Therapy Center LLC
Clinic/Center in Fort Myers, FL. Organization (NPI-2).
NPI number1972111425
StatusActive
Last updated in NPPESAug 3, 2020
Details
- NPI
- 1972111425
- Entity type
- Organization (NPI-2)
- Legal business name
- Blue Bridge Therapy Center LLC
- Organization subpart
- No
- Enumeration date
- Jul 21, 2020
- Certification date
- Aug 3, 2020
- Last updated
- Aug 3, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
| 103K00000X | Behavior Analyst | – | – | |
| 235Z00000X | Speech-Language Pathologist, | – | – |
Practice location
4531 Deleon St Ste 212Fort Myers, FL 33907-1279
Phone 786-534-8773
Mailing address
4531 Deleon St Ste 212Fort Myers, FL 33907-1279
Phone 786-534-8773
Authorized official
Dayani Aguirre
Co Owner
7865348773
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