Organization
THE INDIGO CHILD THERAPEUTIC LLC
Active
Other names
TIC Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TIFFANY DICKS (OWNER)
(240) 244-9778
Entity
Organization
Contact information
Practice address
7491 OLD ALEXANDRIA FERRY RD, CLINTON, MD 20735-1834
(240) 244-9778
(240) 269-7799
Mailing address
9722 GREEN APPLE TURN, UPPER MARLBORO, MD 20772-4423
(240) 244-9778
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
02/02/2021
Last updated
10/22/2024
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