Organization
PEACOCK AUTISM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
POONAM NANDAL (OWNER)
(302) 306-4395
Entity
Organization
Contact information
Practice address
6818 FORDCREST RD, ROSEDALE, MD 21237-2187
(443) 636-6003
(443) 684-2809
Mailing address
6818 FORDCREST RD, ROSEDALE, MD 21237-2187
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
03/15/2025
Last updated
03/15/2025
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