Individual
MADISON ASHLEY ROOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7090 SAMUEL MORSE DR STE 100, COLUMBIA, MD 21046-3444
(724) 933-4673
Mailing address
1309 LIGHT ST, BALTIMORE, MD 21230-4307
(412) 926-8558
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-56938
MD
106S00000X
Behavior Technician
—
—
Other
Enumeration date
05/31/2020
Last updated
03/08/2022
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