Organization
THE PEDIATRIC AUTISM CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHANTE NICOLE DIX MA, BCBA (CEO)
(478) 273-9199
Entity
Organization
Contact information
Practice address
4304 EAGLE TRACE CT, WALDORF, MD 20602-3116
(478) 273-9199
Mailing address
4304 EAGLE TRACE CT, WALDORF, MD 20602-3116
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
06/06/2021
Last updated
06/06/2021
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