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Organization

FUNDAMENTAL BEHAVIOR SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
COLLEEN WILLIAMS BCBA (EXECUTIVE DIRECTOR)
(240) 361-7178
Entity
Organization

Contact information

Practice address
554 N FREDERICK AVE # 345, GAITHERSBURG, MD 20877-2504
(240) 361-7178
Mailing address
554 N FREDERICK AVE # 345, GAITHERSBURG, MD 20877-2504
(240) 361-7178

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-11-8537
CT
251C00000X
Developmentally Disabled Services Day Training Agency
251S00000X
Community/Behavioral Health Agency
252Y00000X
Early Intervention Provider Agency
253Z00000X
In Home Supportive Care Agency
Primary

Other

Enumeration date
09/13/2011
Last updated
02/28/2012
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