Individual
MARYAM BOLOUKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3450 ELLICOTT CENTER DR STE 205, ELLICOTT CITY, MD 21043-4667
(301) 265-6442
Mailing address
7903 ORION CIR UNIT 340, LAUREL, MD 20724-3111
(301) 265-6442
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
LBA2100
MD
Other
Enumeration date
12/06/2021
Last updated
07/18/2025
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