Organization
MAGNOLIA AUTISM GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
QINGQING MAO (CTO)
(415) 805-1725
Entity
Organization
Contact information
Practice address
822 GUILFORD AVE # 1555, BALTIMORE, MD 21202-3707
(510) 457-1492
Mailing address
440 N BARRANCA AVE # 9605, COVINA, CA 91723-1722
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
02/26/2024
Last updated
04/08/2026
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