Individual
CHADEA LAWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 E PRATT ST FL 8, BALTIMORE, MD 21202-3180
(855) 832-6727
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
(443) 983-3787
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-78247
MD
Other
Enumeration date
01/17/2019
Last updated
07/14/2020
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