Provider Demographics
NPI:1265671135
Name:BLODGETT, ALLISON JOY (BCBA)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:JOY
Last Name:BLODGETT
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:175 MIDDLE ST
Mailing Address - Street 2:SUITE 1201
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-3625
Mailing Address - Country:US
Mailing Address - Phone:866-610-0580
Mailing Address - Fax:866-610-0580
Practice Address - Street 1:515 PALM COAST PKWY SW
Practice Address - Street 2:SUITE 6
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-4739
Practice Address - Country:US
Practice Address - Phone:386-951-3044
Practice Address - Fax:866-610-0580
Is Sole Proprietor?:No
Enumeration Date:2009-02-16
Last Update Date:2016-11-22
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker