Organization
ASABA THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN TYBERG (DIRECTOR)
(410) 541-1316
Entity
Organization
Contact information
Practice address
124 SLADE AVE STE 110, BALTIMORE, MD 21208-4900
(410) 541-1316
Mailing address
124 SLADE AVE STE 110, BALTIMORE, MD 21208-4900
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/16/2024
Last updated
02/16/2024
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