Organization
BLUE BALLOON INDIAN CREEK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARIAM NEWMARK M.ED, BCBA, LBA (CLINICAL DIRECTOR)
(201) 216-9500
Entity
Organization
Contact information
Practice address
12240 INDIAN CREEK CT STE 100, BELTSVILLE, MD 20705-1242
(201) 216-9500
Mailing address
175 BELGROVE DR, KEARNY, NJ 07032-1507
(201) 216-9500
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
103T00000X
Psychologist
—
—
Other
Enumeration date
04/02/2024
Last updated
04/02/2024
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