Organization
CLOVER BEHAVIOR CONSULTING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLEEN WILLIAMS (EXECUTIVE DIRECTOR)
(240) 304-6604
Entity
Organization
Contact information
Practice address
402 KING FARM BLVD, ROCKVILLE, MD 20850
(240) 304-6604
Mailing address
402 KING FARM BLVD, ROCKVILLE, MD 20850-5843
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1118537
MD
106S00000X
Behavior Technician
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861759359
NPI
MD
Enumeration date
08/23/2017
Last updated
08/23/2017
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