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Organization
BLUE BALLOON MD LLC
Active
Organization
BLUE BALLOON MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID SUSSMAN (COO)
(201) 216-9500
Entity
Organization
Contact information
Practice address
500 REDLAND CT STE 102, OWINGS MILLS, MD 21117-3265
(201) 216-9500
Mailing address
500 REDLAND CT STE 102, OWINGS MILLS, MD 21117-3265
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
NULL
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
NULL
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
06/16/2021
Last updated
06/16/2021
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