Organization
PLATINUM THERAPEUTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA GINGRAS BCBA, LBA (CEO)
(913) 522-7159
Entity
Organization
Contact information
Practice address
2412 COMPTROLLERS CT, PRINCE FREDERICK, MD 20678-4340
(913) 522-7159
Mailing address
2412 COMPTROLLERS CT, PRINCE FREDERICK, MD 20678-4340
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679039598
NPI
MD
Enumeration date
03/31/2022
Last updated
11/21/2024
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