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Organization
FUNDAMENTAL BEHAVIOR SERVICES, LLC
Active
Organization
FUNDAMENTAL BEHAVIOR SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLEEN WILLIAMS BCBA (EXECUTIVE DIRECTOR)
(240) 361-7178
Entity
Organization
Contact information
Practice address
554 N FREDERICK AVE # 345, GAITHERSBURG, MD 20877-2504
(240) 361-7178
Mailing address
554 N FREDERICK AVE # 345, GAITHERSBURG, MD 20877-2504
(240) 361-7178
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-11-8537
CT
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
09/13/2011
Last updated
02/28/2012
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