Organization
AUTISM BEHAVIOR CONNECTION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEAORA WAGNER BCBA (OWNER)
(301) 693-8479
Entity
Organization
Contact information
Practice address
1043 ORNDORFF CT, BRUNSWICK, MD 21716-1219
(301) 693-8479
Mailing address
1043 ORNDORFF CT, BRUNSWICK, MD 21716-1219
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-3-14102
BACB BCBA CERTIFICATION
MD
Enumeration date
04/26/2015
Last updated
04/26/2015
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