Individual
TERESA GINGRAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2412 COMPTROLLERS CT, PRINCE FREDERICK, MD 20678-4340
(443) 295-3015
Mailing address
2412 COMPTROLLERS CT, PRINCE FREDERICK, MD 20678-4340
(913) 522-7159
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-48616
—
106S00000X
Behavior Technician
RBT-16-18837
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
483106300
—
MD
Enumeration date
02/15/2019
Last updated
01/02/2023
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