Provider Demographics
NPI:1013788975
Name:LITTLE BLOSSOMS ABA LTD.
Entity Type:Organization
Organization Name:LITTLE BLOSSOMS ABA LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:BROOKE
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-734-5957
Mailing Address - Street 1:7492 PRESSLER GRV APT C
Mailing Address - Street 2:
Mailing Address - City:FORT KNOX
Mailing Address - State:KY
Mailing Address - Zip Code:40121-2255
Mailing Address - Country:US
Mailing Address - Phone:270-734-5957
Mailing Address - Fax:
Practice Address - Street 1:7492 PRESSLER GRV APT C
Practice Address - Street 2:
Practice Address - City:FORT KNOX
Practice Address - State:KY
Practice Address - Zip Code:40121-2255
Practice Address - Country:US
Practice Address - Phone:270-734-5957
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty